Lenalidomide as maintenance treatment for patients with multiple myeloma after autologous stem cell transplantation: A pharmaco-economic assessment

Carin A. Uyl-de Groot; Rachel Ramsden; Dawn Lee; Janneke Boersma; Sonja Zweegman; Sujith Dhanasiri

doi:10.1111/ejh.13497

Lenalidomide as maintenance treatment for patients with multiple myeloma after autologous stem cell transplantation: A pharmaco-economic assessment

Carin A. Uyl-de Groot^*, Rachel Ramsden, Dawn Lee, Janneke Boersma, Sonja Zweegman, Sujith Dhanasiri

^*Corresponding author for this work

Health Technology Assessment (HTA)

Research output: Contribution to journal › Article › Academic › peer-review

7 Citations (Scopus)

Abstract

Objective: Autologous stem cell transplantation (ASCT) has improved progression-free survival (PFS) and overall survival in eligible patients with newly diagnosed multiple myeloma (NDMM); however, relapse occurs. Maintenance therapy with lenalidomide (Len-Mt) extends survival and delays relapse and the subsequent initiation of costly second-line regimens. Here, we report the cost-effectiveness of Len-Mt following ASCT from a Dutch healthcare service perspective. Methods: A partitioned survival model was developed to assess the lifetime costs and benefits for patients with NDMM. Efficacy was taken from a pooled meta-analysis of clinical trial data. Costs and subsequent therapy data were taken from sources appropriate for the Dutch market. Results: Lenalidomide produced a quality-adjusted life year gain of 2.46 and a life year gain of 2.79 vs no maintenance treatment. The cost of lenalidomide was partially offset by savings of EUR 77 462 in subsequent treatment costs. The incremental cost-effectiveness ratio of Len-Mt vs no maintenance treatment was EUR 30 143. Key model drivers included subsequent therapies, dosing schedule, and time horizon. Conclusion: Lenalidomide is cost-effective after ASCT vs no maintenance therapy in the Netherlands. By extending PFS, lenalidomide delays the cost burdens associated with relapse and subsequent treatment lines.

Original language	English
Pages (from-to)	635-645
Number of pages	11
Journal	European Journal of Haematology
Volume	105
Issue number	5
DOIs	https://doi.org/10.1111/ejh.13497
Publication status	Published - 20 Jul 2020

Bibliographical note

Funding Information:
C. A. U‐dG. has received research funding from Amgen, Astellas, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Genzyme, Gilead, Janssen‐Cilag, Merck, Roche, and Sanofi. RR is employed by BresMed and is a consultant for Bristol Myers Squibb. DL is employed by BresMed and is a consultant for Bristol Myers Squibb. JB is employed by Roche. SZ has received research funding and honoraria from Bristol Myers Squibb, Janssen, and Takeda. SD is employed by Celgene International, a Bristol Myers Squibb Company, and has equity interest.

Publisher Copyright:
© 2020 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.

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10.1111/ejh.13497

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@article{f1e4d2f9bd6e4b4ca2474cbbff21b0c6,

title = "Lenalidomide as maintenance treatment for patients with multiple myeloma after autologous stem cell transplantation: A pharmaco-economic assessment",

abstract = "Objective: Autologous stem cell transplantation (ASCT) has improved progression-free survival (PFS) and overall survival in eligible patients with newly diagnosed multiple myeloma (NDMM); however, relapse occurs. Maintenance therapy with lenalidomide (Len-Mt) extends survival and delays relapse and the subsequent initiation of costly second-line regimens. Here, we report the cost-effectiveness of Len-Mt following ASCT from a Dutch healthcare service perspective. Methods: A partitioned survival model was developed to assess the lifetime costs and benefits for patients with NDMM. Efficacy was taken from a pooled meta-analysis of clinical trial data. Costs and subsequent therapy data were taken from sources appropriate for the Dutch market. Results: Lenalidomide produced a quality-adjusted life year gain of 2.46 and a life year gain of 2.79 vs no maintenance treatment. The cost of lenalidomide was partially offset by savings of EUR 77 462 in subsequent treatment costs. The incremental cost-effectiveness ratio of Len-Mt vs no maintenance treatment was EUR 30 143. Key model drivers included subsequent therapies, dosing schedule, and time horizon. Conclusion: Lenalidomide is cost-effective after ASCT vs no maintenance therapy in the Netherlands. By extending PFS, lenalidomide delays the cost burdens associated with relapse and subsequent treatment lines.",

author = "\{Uyl-de Groot\}, \{Carin A.\} and Rachel Ramsden and Dawn Lee and Janneke Boersma and Sonja Zweegman and Sujith Dhanasiri",

note = "Funding Information: C. A. U‐dG. has received research funding from Amgen, Astellas, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Genzyme, Gilead, Janssen‐Cilag, Merck, Roche, and Sanofi. RR is employed by BresMed and is a consultant for Bristol Myers Squibb. DL is employed by BresMed and is a consultant for Bristol Myers Squibb. JB is employed by Roche. SZ has received research funding and honoraria from Bristol Myers Squibb, Janssen, and Takeda. SD is employed by Celgene International, a Bristol Myers Squibb Company, and has equity interest. Publisher Copyright: {\textcopyright} 2020 The Authors. European Journal of Haematology published by John Wiley \& Sons Ltd.",

year = "2020",

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doi = "10.1111/ejh.13497",

language = "English",

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TY - JOUR

T1 - Lenalidomide as maintenance treatment for patients with multiple myeloma after autologous stem cell transplantation

T2 - A pharmaco-economic assessment

AU - Uyl-de Groot, Carin A.

AU - Ramsden, Rachel

AU - Lee, Dawn

AU - Boersma, Janneke

AU - Zweegman, Sonja

AU - Dhanasiri, Sujith

N1 - Funding Information: C. A. U‐dG. has received research funding from Amgen, Astellas, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Genzyme, Gilead, Janssen‐Cilag, Merck, Roche, and Sanofi. RR is employed by BresMed and is a consultant for Bristol Myers Squibb. DL is employed by BresMed and is a consultant for Bristol Myers Squibb. JB is employed by Roche. SZ has received research funding and honoraria from Bristol Myers Squibb, Janssen, and Takeda. SD is employed by Celgene International, a Bristol Myers Squibb Company, and has equity interest. Publisher Copyright: © 2020 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.

PY - 2020/7/20

Y1 - 2020/7/20

N2 - Objective: Autologous stem cell transplantation (ASCT) has improved progression-free survival (PFS) and overall survival in eligible patients with newly diagnosed multiple myeloma (NDMM); however, relapse occurs. Maintenance therapy with lenalidomide (Len-Mt) extends survival and delays relapse and the subsequent initiation of costly second-line regimens. Here, we report the cost-effectiveness of Len-Mt following ASCT from a Dutch healthcare service perspective. Methods: A partitioned survival model was developed to assess the lifetime costs and benefits for patients with NDMM. Efficacy was taken from a pooled meta-analysis of clinical trial data. Costs and subsequent therapy data were taken from sources appropriate for the Dutch market. Results: Lenalidomide produced a quality-adjusted life year gain of 2.46 and a life year gain of 2.79 vs no maintenance treatment. The cost of lenalidomide was partially offset by savings of EUR 77 462 in subsequent treatment costs. The incremental cost-effectiveness ratio of Len-Mt vs no maintenance treatment was EUR 30 143. Key model drivers included subsequent therapies, dosing schedule, and time horizon. Conclusion: Lenalidomide is cost-effective after ASCT vs no maintenance therapy in the Netherlands. By extending PFS, lenalidomide delays the cost burdens associated with relapse and subsequent treatment lines.

AB - Objective: Autologous stem cell transplantation (ASCT) has improved progression-free survival (PFS) and overall survival in eligible patients with newly diagnosed multiple myeloma (NDMM); however, relapse occurs. Maintenance therapy with lenalidomide (Len-Mt) extends survival and delays relapse and the subsequent initiation of costly second-line regimens. Here, we report the cost-effectiveness of Len-Mt following ASCT from a Dutch healthcare service perspective. Methods: A partitioned survival model was developed to assess the lifetime costs and benefits for patients with NDMM. Efficacy was taken from a pooled meta-analysis of clinical trial data. Costs and subsequent therapy data were taken from sources appropriate for the Dutch market. Results: Lenalidomide produced a quality-adjusted life year gain of 2.46 and a life year gain of 2.79 vs no maintenance treatment. The cost of lenalidomide was partially offset by savings of EUR 77 462 in subsequent treatment costs. The incremental cost-effectiveness ratio of Len-Mt vs no maintenance treatment was EUR 30 143. Key model drivers included subsequent therapies, dosing schedule, and time horizon. Conclusion: Lenalidomide is cost-effective after ASCT vs no maintenance therapy in the Netherlands. By extending PFS, lenalidomide delays the cost burdens associated with relapse and subsequent treatment lines.

UR - https://www.scopus.com/pages/publications/85091246485

U2 - 10.1111/ejh.13497

DO - 10.1111/ejh.13497

M3 - Article

C2 - 32705720

AN - SCOPUS:85091246485

SN - 0902-4441

VL - 105

SP - 635

EP - 645

JO - European Journal of Haematology

JF - European Journal of Haematology

IS - 5

ER -

Lenalidomide as maintenance treatment for patients with multiple myeloma after autologous stem cell transplantation: A pharmaco-economic assessment

Abstract

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