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Cost-Effectiveness Analysis of Adding Daratumumab to a Regimen of Bortezomib, Melphalan, and Prednisone in Newly Diagnosed Multiple Myeloma

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Abstract

Introduction

The ALCYONE trial found that daratumumab in combination with bortezomib, melphalan, and prednisone (D-VMP) can significantly improve progression-free survival (PFS) and overall survival (OS) for patients with transplant-ineligible, newly diagnosed multiple myeloma (MM) in China. In the present study, we evaluated the cost-effectiveness of D-VMP versus VMP for patients with newly diagnosed MM in China.

Methods

A Markov model was used to estimate the cost-effectiveness of frontline D-VMP versus VMP for MM. The life years (LYs), quality-adjusted LYs (QALYs), and incremental cost-effectiveness ratio (ICER) were calculated. A series of sensitivity analyses was performed to assess the robustness of the model and address uncertainties in variable estimates. Subgroup analysis was also performed.

Results

D-VMP provided an additional 2.99 LYs and 1.67 QALYs compared with VMP, with incremental $64,920 per LY and $116,015 per QALY gained. The results of the univariable sensitivity analysis showed that the parameter that had the greatest impact on the ICER was the cost of subsequent treatment and daratumumab. When the cost of daratumumab was 100%, 70%, 50%, and 30% of the current price, the probability of D-VMP being cost-effective was 2.49%, 16.11%, 39.09%, and 70.73% at the willingness-to-pay (WTP) threshold of $30,950/QALY, respectively. The results demonstrated that the ICER in all subgroups remained > $30,950/QALY.

Conclusion

D-VMP versus VMP is likely to exceed the commonly accepted values of cost-effectiveness in patients with transplant-ineligible, newly diagnosed MM in China.

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Acknowledgements

Funding

The work and the journal’s Rapid Service Fee were supported by grants from the National Natural Science Foundation of China (grant numbers: 81401547, 81603081, 82073818, and 71874209), the Key Science-Technology Research and Development Program of Hunan Province (grant number: 2016JC2062 and 2020JJ8046), and the Hunan Provincial Natural Science Foundation of China (grant number: 2019JJ40411).

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

Xiaohui Zeng, QiaoLiu, Liubao Peng, Ye Peng, Lidan Yi, Xia Luo, Sini Li, Xiaomin Wan, and Chongqing Tan have nothing to disclose.

Compliance with Ethics Guidelines

This article is based on a retrospective study and does not contain any studies with human participants or animals performed by any of the authors.

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author notes

  1. Xiaohui Zeng and Qiao Liu contributed equally to this work.

Authors and Affiliations

  1. PET-CT Center, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China

    Xiaohui Zeng

  2. Department of Pharmacy, The Second Xiangya Hospital of Central South University, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China

    Qiao Liu, Liubao Peng, Ye Peng, Lidan Yi, Xia Luo, Sini Li, Xiaomin Wan & Chongqing Tan

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  1. Xiaohui Zeng
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Correspondence to Xiaomin Wan or Chongqing Tan.

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Zeng, X., Liu, Q., Peng, L. et al. Cost-Effectiveness Analysis of Adding Daratumumab to a Regimen of Bortezomib, Melphalan, and Prednisone in Newly Diagnosed Multiple Myeloma. Adv Ther 38, 2379–2390 (2021). https://doi.org/10.1007/s12325-021-01699-6

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