OBJECTIVES: Ide-cel, a BCMA-directed CAR T cell therapy has shown a favorable clinical benefit-risk profile in triple-class exposed patients with RRMM in the ongoing, phase 2, multicenter, single-arm KarMMa clinical trial (NCT03361748). This analysis evaluated healthcare resource utilization (HCRU) and estimated 1-year cost of care among patients treated within the KarMMa clinical trial.

METHODS: HCRU data were analyzed from the KarMMa clinical trial database, including hospital length of stay (LOS) (standard inpatient [IP] and intensive care unit [ICU] days), diagnostics, procedures, and medications. Data were analyzed from day of ide-cel infusion through 1-year of follow-up. Post-infusion costs were estimated using a micro-costing methodology. Unit costs were sourced from public databases or US health system (provider) perspective literature, adjusted to 2020 USD, and applied to each HCRU. Average total cost by ide-cel post-infusion month was calculated among patients with ongoing status in that month. Patients censored because of data cutoff were excluded.

RESULTS: 128 patients received ide-cel infusions. Most patients received corticosteroids and antibiotics, 13.3% had vasopressor use. Few patients required dialysis (0.8%) or intubation (3.9%) and a minority (19.5%) had an ICU stay. Among all patients, mean (standard deviation [SD]) LOS was 21.4 (12.0) days for IP and 1.3 (3.4) days for ICU stays. Total LOS ranged between 15 to 114 days with a mean (SD) of 22.7 (12.5) days (protocol required IP stay ≥14 days). The estimated mean 1-year post-infusion total cost of care was USD 107,699. Most (58.0%) 1-year costs were incurred in the first month following infusion and were primarily driven by facility costs, namely standard IP and ICU stays.

CONCLUSIONS: In the KarMMa clinical trial, most costs after ide-cel infusion were incurred during the first month and were related to facility use. Following the immediate infusion period, ide-cel was associated with significantly reduced HCRU and costs.