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The Cost Impact of Lenalidomide for Newly Diagnosed Multiple Myeloma in the EU5

Authors
  • Schey, Steve1
  • Montero, Luis Felipe Casado2
  • Stengel-Tosetti, Chloe3
  • Gibson, Craig J.4
  • Dhanasiri, Sujith5
  • 1 King’s College Hospital, London, UK , London (United Kingdom)
  • 2 Hospital Virgen de la Salud, Toledo, Spain , Toledo (Spain)
  • 3 Dolon Ltd., London, UK , London (United Kingdom)
  • 4 Celgene Corporation, Summit, NJ, USA , Summit (United States)
  • 5 Celgene International, Boudry, Switzerland , Boudry (Switzerland)
Type
Published Article
Journal
Oncology and Therapy
Publisher
Springer Healthcare
Publication Date
Jan 03, 2017
Volume
5
Issue
1
Pages
31–40
Identifiers
DOI: 10.1007/s40487-016-0037-8
Source
Springer Nature
Keywords
License
Green

Abstract

IntroductionLenalidomide is an active agent that was approved for use in the EU in 2015 as a first-line therapy for previously untreated, non-transplant eligible multiple myeloma patients. Our objective was to assess the cost impact of lenalidomide when selected as a first-line treatment for transplant-ineligible patients in France, Germany, Italy, Spain, and the United Kingdom (EU5).MethodsWe developed a cost-impact model of the total costs associated with newly diagnosed multiple myeloma over 5 years in the EU5 based on treatment duration and time to progression (TTP) (taken from trial data). We compared a baseline scenario (of current lenalidomide uptake) with two alternative future scenarios. Future Scenario A used an increased uptake of first-line lenalidomide: up to 50% in Year 5. Future Scenario B was similar to the baseline, but included a 20% increased uptake of the triple therapy regimen, carfilzomib, lenalidomide, and dexamethasone (KRd) at second line.ResultsCompared to alternative first-line care pathways, lenalidomide provides a time to progression advantage of up to 5.1 months. In the baseline scenario, the costs per patient were €40,692 in Year 1. Future Scenario A showed an additional expenditure of €867 per patient in Year 1, increasing to €3358 per patient by Year 5, a 2.1% and 8.2% increase from baseline, respectively. However, lenalidomide use was associated with a lower monthly hospitalisation per-patient cost (€813) compared with bortezomib (€1173) and thalidomide (€1532). Future Scenario B was associated with a 29% increase in cost.ConclusionsCompared to other first line therapies, lenalidomide delays time to progression resulting in associated savings across a patient’s treatment pathway and overall is likely to result in a limited impact on budget. Lenalidomide should, therefore, be considered as a first treatment option for multiple myeloma patients ineligible for transplant.FundingCelgene Ltd.

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