Navigating the Economic Burden of Multiple Myeloma: Insights into Cost-effectiveness of CAR-T and Bispecific Antibody Therapies

Overview

Journal Curr Hematol Malig Rep

Publisher Current Science

Specialties Hematology
Oncology

Date 2025 Jan 4

PMID 39754658

Authors

Praneeth Reddy Keesari

Diana Samuels

Charan Thej Reddy Vegivinti

Yashwitha Sai Pulakurthi

Revathi Kudithi

Meekoo Dhar

Murali Janakiram

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: Multiple myeloma is a chronic malignancy and with evolving treatment options, understanding the economic burden and cost-effectiveness of therapies is crucial for clinicians and researchers.

Recent Findings: In this, we review the recent approval of Bispecific antibodies and CAR-T for myeloma and their cost implications, including direct and indirect costs. We compare this to current regimens and provide cost comparisons in this review. We conclude that the use of more effective therapies such as CAR-T in earlier lines of therapies may be more cost-effective depending on the country and model used. Further studies are essential to better understand the cost-effectiveness of bispecific antibodies including head-to-head comparisons to CAR-T therapy.

References

Jackson G, Galinsky J, Alderson D, DSouza V, Buchanan V, Dhanasiri S . Productivity losses in patients with newly diagnosed multiple myeloma following stem cell transplantation and the impact of maintenance therapy. Eur J Haematol. 2019; 103(4):393-401. PMC: 6899492. DOI: 10.1111/ejh.13298. View

Ravi G, Costa L . Bispecific T-cell engagers for treatment of multiple myeloma. Am J Hematol. 2022; 98 Suppl 2:S13-S21. DOI: 10.1002/ajh.26628. View

Barr H, Guggenbickler A, Hoch J, Dewa C . Real-World Cost-Effectiveness Analysis: How Much Uncertainty Is in the Results?. Curr Oncol. 2023; 30(4):4078-4093. PMC: 10136635. DOI: 10.3390/curroncol30040310. View

Noori M, Yazdanpanah N, Rezaei N . Safety and efficacy of T-cell-redirecting bispecific antibodies for patients with multiple myeloma: a systematic review and meta-analysis. Cancer Cell Int. 2023; 23(1):193. PMC: 10478206. DOI: 10.1186/s12935-023-03045-y. View

Ludwig H, Bolejack V, Crowley J, Blade J, San Miguel J, Kyle R . Survival and years of life lost in different age cohorts of patients with multiple myeloma. J Clin Oncol. 2010; 28(9):1599-605. DOI: 10.1200/JCO.2009.25.2114. View

Bayani D, Lin Y, Ooi M, Tso A, Wee H . Real-world utilization and healthcare costs for multiple myeloma: A retrospective analysis of patients in Singapore. EJHaem. 2023; 4(4):1013-1018. PMC: 10660121. DOI: 10.1002/jha2.798. View

Liu Y, An L, Huang R, Xiong J, Yang H, Wang X . Strategies to enhance CAR-T persistence. Biomark Res. 2022; 10(1):86. PMC: 9685914. DOI: 10.1186/s40364-022-00434-9. View

Choon-Quinones M, Zelei T, Barnett M, Keown P, Durie B, Kalo Z . Beyond medicines' barriers: exploring the true cost of multiple myeloma. J Med Econ. 2022; 25(1):1167-1175. DOI: 10.1080/13696998.2022.2133823. View

Beinfeld M, Lee S, McQueen B, Fluetsch N, Pearson S, Ollendorf D . Anti B-cell maturation antigen CAR T-cell and antibody drug conjugate therapy for heavily pretreated relapsed and refractory multiple myeloma. J Manag Care Spec Pharm. 2021; 27(9):1315-1320. PMC: 10391002. DOI: 10.18553/jmcp.2021.27.9.1315. View

10.

Yang J, Boytsov N, Carlson J, Barthold D . Health care resource utilization and costs among patients with multiple myeloma with exposure to double-class or triple-class multiple myeloma treatments: A retrospective US claims database analysis. J Manag Care Spec Pharm. 2023; 29(8):917-926. PMC: 10397331. DOI: 10.18553/jmcp.2023.29.8.917. View

11.

Robinson Jr D, Orlowski R, Stokes M, He J, Huse S, Chitnis A . Economic burden of relapsed or refractory multiple myeloma: Results from an international trial. Eur J Haematol. 2017; 99(2):119-132. DOI: 10.1111/ejh.12876. View

12.

Wu W, Ding S, Mingming Z, Yuping Z, Sun X, Zhao Z . Cost effectiveness analysis of CAR-T cell therapy for patients with relapsed/refractory multiple myeloma in China. J Med Econ. 2023; 26(1):701-709. DOI: 10.1080/13696998.2023.2207742. View

13.

Madduri D, Hagiwara M, Parikh K, Pelletier C, Delea T, Kee A . Real-world treatment patterns, healthcare use and costs in triple-class exposed relapsed and refractory multiple myeloma patients in the USA. Future Oncol. 2021; 17(5):503-515. DOI: 10.2217/fon-2020-1003. View

14.

Kapinos K, Hu E, Trivedi J, Ramakrishnan Geethakumari P, Kansagra A . Cost-Effectiveness Analysis of CAR T-Cell Therapies vs Antibody Drug Conjugates for Patients with Advanced Multiple Myeloma. Cancer Control. 2023; 30:10732748221142945. PMC: 9869188. DOI: 10.1177/10732748221142945. View

15.

Ashcroft J, Judge D, Dhanasiri S, Taylor-Stokes G, Middleton C . Chart review across EU5 in MM post-ASCT patients. Int J Hematol Oncol. 2018; 7(1):IJH05. PMC: 6176952. DOI: 10.2217/ijh-2018-0004. View

16.

Rajkumar S . Value and Cost of Myeloma Therapy. Am Soc Clin Oncol Educ Book. 2018; 38:662-666. DOI: 10.1200/EDBK_200867. View

17.

Hollmann S, Moldaver D, Goyert N, Grima D, Maiese E . A U.S. Cost Analysis of Triplet Regimens for Patients with Previously Treated Multiple Myeloma. J Manag Care Spec Pharm. 2019; 25(4):449-459. PMC: 10397865. DOI: 10.18553/jmcp.2019.25.4.449. View

18.

Carta A, Conversano C . On the Use of Markov Models in Pharmacoeconomics: Pros and Cons and Implications for Policy Makers. Front Public Health. 2020; 8:569500. PMC: 7661756. DOI: 10.3389/fpubh.2020.569500. View

19.

Lee H, Ahn S, Maity R, Leblay N, Ziccheddu B, Truger M . Mechanisms of antigen escape from BCMA- or GPRC5D-targeted immunotherapies in multiple myeloma. Nat Med. 2023; 29(9):2295-2306. PMC: 10504087. DOI: 10.1038/s41591-023-02491-5. View

20.

Merola D, Yong C, Noga S, Shermock K . Costs Associated with Productivity Loss Among U.S. Patients Newly Diagnosed with Multiple Myeloma Receiving Oral Versus Injectable Chemotherapy. J Manag Care Spec Pharm. 2018; 24(10):1019-1026. PMC: 10397991. DOI: 10.18553/jmcp.2018.24.10.1019. View