OBJECTIVES: The objective of this study was to map the current therapeutic pathway in order to estimate MM disease management cost and investigate the economic implications for EOPYY from the introduction of novel agents in clinical practice.

METHODS: An expert panel consisting of special hematologists from public hospitals was asked to document patient distribution within the different treatment lines, regimens and resource use and extract corresponding estimations for the next 2-3 years, based on the reallocation of patients to treatment lines due to the introduction of newer regimens. Cost analysis was carried out from the social security perspective based on national reimbursed prices and DRGs tariffs.

RESULTS: Approximately 400-500 patients are diagnosed each year in Greece, within a total estimated of 1,600 to 2,000 patients. Amongst those submitted to anti-myeloma treatment, about 27% resides in a different prefecture than the one being treated. Annual burden was estimated at €77.7 mln (€48,536/patient) due to current treatment regimens vs. €95 mln (€59,318/patient) related to the introduction of novel regimens in the near future, reaching at 8.5% of the public expenditure on all types of cancer. Approximately 87.5% of the annual cost was related to drugs, followed by prophylaxis and optimum supportive care cost (about 6%). Among patients in the line referring to the first relapse following a regimen containing a proteasome inhibitor, about 2/3 is estimated to receive (in the near future) DRd or KRd and 9.2% IRd (orally administered). The respective line is estimated to be the most costly (€24.5 mln/year) due to increased use of novel agents. However, annual cost of IRd (€2.5 mln/year) contributes less than 10% to overall cost of this line.

CONCLUSIONS: Despite novel agents’ high cost, emphasis needs to be placed on measuring the value of care, taking into consideration improved outcomes correlated to novel regimens.