Lenalidomide for multiple myeloma: cost-effectiveness in patients with one prior therapy in England and Wales

TY - JOUR

T1 - Lenalidomide for multiple myeloma

T2 - cost-effectiveness in patients with one prior therapy in England and Wales

AU - Brown, Ruth E.

AU - Stern, Sean

AU - Dhanasiri, Sujith

AU - Schey, Stephen

PY - 2013/6

Y1 - 2013/6

N2 - Purpose To determine the cost effectiveness of lenalidomide plus dexamethasone (LEN/DEX) versus DEX alone in managing multiple myeloma (MM) patients who have failed one prior therapy. Materials and Methods An individual simulation model was designed to capture the costs and outcomes of LEN/DEX versus DEX therapy in relapsed refractory MM patients. MM009/010 efficacy data were adjusted for treatment cross-over and extrapolated to patient lifetime. Resource use for MM disease progression and adverse events were obtained from expert physicians and costed from the perspective of the National Health Service (England and UK) and included a patient access scheme for LEN. Utility values were obtained from published literature. Results The simulation model estimated an incremental improvement in time to progression of 9.5 months, an additional 3.2 life-years, and 2.2 quality adjusted life years (QALY) for LEN/DEX compared to DEX alone. Including the costs of therapy with the patient access scheme, adverse events, and disease follow-up, the incremental cost effectiveness ratio was A 30,153 pound/QALY for LEN/DEX compared to DEX alone in MM patients who have failed one prior therapy. Conclusion LEN/DEX is a cost effective oncology therapy from the perspective of the NHS for MM patients with one prior treatment.

AB - Purpose To determine the cost effectiveness of lenalidomide plus dexamethasone (LEN/DEX) versus DEX alone in managing multiple myeloma (MM) patients who have failed one prior therapy. Materials and Methods An individual simulation model was designed to capture the costs and outcomes of LEN/DEX versus DEX therapy in relapsed refractory MM patients. MM009/010 efficacy data were adjusted for treatment cross-over and extrapolated to patient lifetime. Resource use for MM disease progression and adverse events were obtained from expert physicians and costed from the perspective of the National Health Service (England and UK) and included a patient access scheme for LEN. Utility values were obtained from published literature. Results The simulation model estimated an incremental improvement in time to progression of 9.5 months, an additional 3.2 life-years, and 2.2 quality adjusted life years (QALY) for LEN/DEX compared to DEX alone. Including the costs of therapy with the patient access scheme, adverse events, and disease follow-up, the incremental cost effectiveness ratio was A 30,153 pound/QALY for LEN/DEX compared to DEX alone in MM patients who have failed one prior therapy. Conclusion LEN/DEX is a cost effective oncology therapy from the perspective of the NHS for MM patients with one prior treatment.

KW - Lenalidomide

KW - Multiple myeloma

KW - Cost effectiveness

KW - Dexamethasone

KW - Patient access scheme

KW - QUALITY-OF-LIFE

KW - DEXAMETHASONE

KW - CHEMOTHERAPY

KW - COMBINATION

KW - SURVIVAL

KW - RELAPSE

U2 - 10.1007/s10198-012-0395-6

DO - 10.1007/s10198-012-0395-6

M3 - Article

SN - 1618-7598

VL - 14

SP - 507

EP - 514

JO - European Journal of Health Economics

JF - European Journal of Health Economics

IS - 3

ER -