ACCUMULATED TREATMENT COST OF NEW THERAPIES IN MULTIPLE MYELOMA- COMPARING THE COMBINATION OF DARATUMUMAB, BORTEZOMIB AND DEXAMETHASONE WITH CARFILZOMIB AND DEXAMETHASONE FOR WHO HAVE RECEIVED AT LEAST ONE PRIOR THERAPY IN BRAZIL
Author(s)
Del Rey C, Asano E
Janssen, Sao Paulo, Brazil
Presentation Documents
OBJECTIVES:: The aim of this study is to determine treatment costs at 1 to 2 years of of relapsed/refractory Multiple Myeloma patients treated with novel treatment combinations: DVd (Daratumumab+Velcade+dexamethasone) vs K2d (Carfilzomib+dexamethasone). METHODS:: The deterministic model compares accumulated cost per week based on posology detailed in daratumumab and carfilzomib labels in combinations (DVd and K2d) for treatment of relapsed/refractory Multiple Myeloma for a maximum period of 2 years. Only pharmaceutical acquisition costs (official list price) were considered in the analysis. Costs were calculated in two scenarios: a basecase considering standard evaluation (per vial) and an alternative scenario per milligram (considering no waste of substance, using price/miligram). One-way deterministic sensitivity analysis was conducted to assess the robustness of the results. RESULTS:: Due to the difference in posology, DVd accumulated cost curve starts higher than K2d but it eventually becomes lower after 30 to 32 weeks, as disclosed in results found onbase case (standard evaluation per vial), that from week 30 and on K2d becomes more expensive than DVd; and on alternative scenario (per milligram), this point of time is on week 32. After one year of treatment, in our basecase scenario DVd costs reached R$ 596,335 while K2d reached R$ 829,416. In the alternative scenario the costs were R$533,873 for DVd vs. R$ 665,530 for K2d. In two years of analyses, the difference is even higher (total costs 65% to 89% higherfor K2d compared with DVd): R$ 885,300 (DVd) vs. R$1,669,598 (K2d) and R$ 812,864 (DVd) vs. R$ 1,342,208 (K2d) in the basecase and alternative scenario respectively. CONCLUSIONS:: DVd scheme shows a reduced cost burden after week 30 when compared with K2d in the treatment of relapsed/refractory multiple myeloma. Reducing wastage of pharmaceuticals seems to reduce this difference, though it will still range between R$ 131,657 to R$ 529,344 at 1 and 2 years, respectively.
Conference/Value in Health Info
2017-09, ISPOR Latin America 2017, Sao Paulo, Brazil
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCN32
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Oncology