Treatment sequences and drug costs from diagnosis to death in multiple myeloma

M. R. Seefat*, D. G.J. Cucchi, K. Groen, M. L. Donker, K. G. van der Hem, M. Westerman, A. M. Gerrits, A. Beeker, N. W.C.J. van de Donk, H. M. Blommestein, S. Zweegman

*Corresponding author for this work

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Abstract

Novel therapies for multiple myeloma (MM) have improved patient survival, but their high costs strain healthcare budgets. End-of-life phases of treatment are generally the most expensive, however, these high costs may be less justifiable in the context of a less pronounced clinical benefit. To manage drug expenses effectively, detailed information on end-of-life drug administration and costs are crucial. In this retrospective study, we analysed treatment sequences and drug costs from 96 MM patients in the Netherlands who died between January 2017 and July 2019. Patients received up to 16 lines of therapy (median overall survival: 56.5 months), with average lifetime costs of €209 871 (€3111/month; range: €3942–€776 185) for anti-MM drugs. About 85% of patients received anti-MM treatment in the last 3 months before death, incurring costs of €20 761 (range: €70–€50 122; 10% of total). Half of the patients received anti-MM treatment in the last 14 days, mainly fully oral regimens (66%). End-of-life treatment costs are substantial despite limited survival benefits. The use of expensive treatment options is expected to increase costs further. These data serve as a reference point for future cost studies, and further research is needed to identify factors predicting the efficacy and clinical benefit of continuing end-of-life therapy.

Original languageEnglish
Pages (from-to)360-366
Number of pages7
JournalEuropean Journal of Haematology
Volume112
Issue number3
Early online date11 Oct 2023
DOIs
Publication statusPublished - Mar 2024

Bibliographical note

Funding Information:
S. Zweegman has received research funding from Celgene, Takeda and Janssen, all paid to their institution; and serves on advisory boards for Janssen, Takeda, Bristol Myers Squibb, Oncopeptides and Sanofi, all paid to their institution. H. M. Blommestein reports consulting role for Pfizer and research funding from BMS‐Celgene, all paid to the institute. N. W. C. J. van de Donk has received research support from Janssen Pharmaceuticals, AMGEN, Celgene, Novartis, Cellectis and BMS, all paid to their institution; and serves in advisory boards for Janssen Pharmaceuticals, AMGEN, Celgene, BMS, Takeda, Roche, Novartis, Bayer, Adaptive and Servier. D. G. J. Cucchi received payments for lectures for Takeda, and conference visit support from Servier, all outside the submitted work. Other authors declare no conflict of interest.

Publisher Copyright:
© 2023 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.

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