BACKGROUND: As new target anti-myeloma drugs are introduced into the market, budget impact analysis is needed to include new drugs into vital and essential drugs (VED) list and government reimbursement programs. Ixazomib is a new oral proteasome inhibitor for the treatment of adult patients with relapsed or refractory multiple myeloma (RRMM) who have received at least one prior therapy.

OBJECTIVES: To estimate the financial consequences to Russian health-care budget in case when ixazomib is added to the formulary for the treatment of RRMM patients as a part of triple lenalidomide and dexamethasone (LD) - containing regimen.

METHODS: The budget impact model compared 2 scenarios: basic scenario without ixazomib (LD only or carfilzomib + LD) and alternative scenario with ixazomib (LD only; carfilzomib + LD; ixazomib + LD). Costs were calculated over a 3-year time horizon and included drug acquisition and administration costs and adverse events treatment costs. We used the data of state statistical surveillance and a survey of haematologists for estimating of morbidity and patient’s distribution between different regimens. Costs were calculated on the basis of the registered wholesale selling prices of medicines from the VED list, the price of the manufacturer proposed for ixazomib in case it is included into the VED list, and financial norms for medical care in the Russian Federation in 2017.

RESULTS: With a gradual increase of ixazomib share in the drug state procurements from 3% to 8% within 3 years budgetary expenditures will decrease by 13.59 million euro in comparison with the basic scenario. Cost savings take place mainly due to lower cost of ixazomib compared with already formally approved carfilzomib and its potential use in outpatient settings.

CONCLUSIONS: Ixazomib-based triple regimen is a cost-saving option for treating RRMM in adult patients who have received at least one prior treatment line.