OBJECTIVES : To measure the utilization of inpatient services and associated costs among patients with relapsed and refractory multiple myeloma (RRMM) in the 1-year following treatment with pomalidomide or daratumumab compared to patients without multiple myeloma (MM) in the US.

METHODS : IQVIA’s Real-World Adjudicated US claims database was used to identify adult patients (≥18 years) with ≥1 claim of pomalidomide or daratumumab (index date), as a proxy for relapse therapy for MM, between January 1, 2012 and February 28, 2018. To be included, patients had to have a diagnosis or treatment claim for MM, a claim of any immunomodulatory drugs and proteasome inhibitors and be continuously enrolled in the health plan ≥180 days prior and ≥360 days post the index date. RRMM patients were matched to a non-MM comparator cohort. Outcomes included inpatient visits, length of stay (LOS), readmission rates, hospitalizations related to commonly encountered adverse events (AEs) among RRMM patients, and hospitalization costs. Descriptive statistics were used to compare outcomes between RRMM and non-MM cohorts.

RESULTS : 292 RRMM patients (mean age = 57.7 years, 60.6% male) were included, of which 289 were matched with non-MM comparator (N=1,445) cohort. Post-matching, a significantly higher proportion of RRMM patients (vs. non-MM patients) had ≥ 1 inpatient visit (51.2% vs. 18.5%), inpatient visits related to hematological AEs (77.0% vs. 26.2%) and hospital readmissions (54.1% vs. 27.7%) (All Ps <.0001). RRMM patients had significantly higher mean [SD] inpatient visits (1.1[1.6] vs. 0.3 [0.7]; P <.0001) and LOS in days (10.5[10.6] vs. 6.8 [6.9]; P=0.005) compared with non-MM patients. Higher inpatient utilization translated to significantly higher mean hospitalization costs for RRMM patients compared to non-MM patients ($56,863 vs. $7,838; P<.0001).

CONCLUSIONS : Use of inpatient services is an important driver of economic burden among RRMM patients. Cost-effective outpatient treatment management strategies for RRMM is warranted to reduce hospitalization costs.