OBJECTIVES: Multiple myeloma (MM) is a progressive, fatal cancer that affects the plasma cells. It accounts for 1% of all malignancies and 10% of all hematological cancers. In Austria, nearly 350 people are newly diagnosed every year. The nationwide, age-standardized incidence of MM for 2015 is 4.9 per 100,000 inhabitants.

The aim of this cost comparison is to analyze differences in resource consumption and costs of treatment alternatives administered in different settings. Oral Ixazomib was compared with infusable Carfilzomib, Elotuzumab and Daratumumab, all in combination with Lenalidomide and Dexamethasone. Daratumumab requires premedication.

METHODS: A costing model with a six month time horizon was developed from the payer’s perspective in 2017 Euros. The main objective of the model was to assess differences in resource consumption (medication, personal, material, monitoring and day clinic) and related costs. In order to conduct the analysis a bottom-up micro-costing approach was carried out. Personal, material and monitoring costs were calculated based on a resource utilization survey via questionnaire.

RESULTS: Total treatment costs for Ixazomib+Lenalidomide+Dexamethasone (IxLenDex) amount to 94,000 € over a time horizon of 6 months. Carfilzomib+Lenalidomide+Dexamethasone (CarLenDex) is associated with 107,762 € and costs for Elotuzumab+Lenalidomide+Dexamethasone (EloLenDex) amount to 137,166 €; Daratumumab+Lenalidomide+Dexamethasone (DarLenDex) accounts for 155,494 € within the same period. Treatment costs for IxLenDex are 65% below DarLenDex costs, 46% lower compared to EloLenDex and 15% under CarLenDex. The lower costs of IxLenDex are partly due to the lack of personal and material costs in the hospital setting as well as costs for the day clinic, as IxLenDex is administered orally compared to CarLenDex, EloLenDex and DarLenDex. Lowest medication costs of CarLenDex were offset by higher drug administration costs.

CONCLUSIONS: The economic-analysis shows that the use of IxLenDex is associated with cost-savings. Oral administration saves resources and relieves the inpatient sector.