Lenalidomide as maintenance treatment for patients with multiple myeloma after autologous stem cell transplantation: A pharmaco‐economic assessment

OBJECTIVE: Autologous stem cell transplantation (ASCT) has improved progression‐free survival (PFS) and overall survival in eligible patients with newly diagnosed multiple myeloma (NDMM); however, relapse occurs. Maintenance therapy with lenalidomide (Len‐Mt) extends survival and delays relapse and...

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Autores principales: Uyl‐de Groot, Carin A., Ramsden, Rachel, Lee, Dawn, Boersma, Janneke, Zweegman, Sonja, Dhanasiri, Sujith
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590122/
https://www.ncbi.nlm.nih.gov/pubmed/32705720
http://dx.doi.org/10.1111/ejh.13497
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author Uyl‐de Groot, Carin A.
Ramsden, Rachel
Lee, Dawn
Boersma, Janneke
Zweegman, Sonja
Dhanasiri, Sujith
author_facet Uyl‐de Groot, Carin A.
Ramsden, Rachel
Lee, Dawn
Boersma, Janneke
Zweegman, Sonja
Dhanasiri, Sujith
author_sort Uyl‐de Groot, Carin A.
collection PubMed
description OBJECTIVE: Autologous stem cell transplantation (ASCT) has improved progression‐free survival (PFS) and overall survival in eligible patients with newly diagnosed multiple myeloma (NDMM); however, relapse occurs. Maintenance therapy with lenalidomide (Len‐Mt) extends survival and delays relapse and the subsequent initiation of costly second‐line regimens. Here, we report the cost‐effectiveness of Len‐Mt following ASCT from a Dutch healthcare service perspective. METHODS: A partitioned survival model was developed to assess the lifetime costs and benefits for patients with NDMM. Efficacy was taken from a pooled meta‐analysis of clinical trial data. Costs and subsequent therapy data were taken from sources appropriate for the Dutch market. RESULTS: Lenalidomide produced a quality‐adjusted life year gain of 2.46 and a life year gain of 2.79 vs no maintenance treatment. The cost of lenalidomide was partially offset by savings of EUR 77 462 in subsequent treatment costs. The incremental cost‐effectiveness ratio of Len‐Mt vs no maintenance treatment was EUR 30 143. Key model drivers included subsequent therapies, dosing schedule, and time horizon. CONCLUSION: Lenalidomide is cost‐effective after ASCT vs no maintenance therapy in the Netherlands. By extending PFS, lenalidomide delays the cost burdens associated with relapse and subsequent treatment lines.
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spelling pubmed-75901222020-10-30 Lenalidomide as maintenance treatment for patients with multiple myeloma after autologous stem cell transplantation: A pharmaco‐economic assessment Uyl‐de Groot, Carin A. Ramsden, Rachel Lee, Dawn Boersma, Janneke Zweegman, Sonja Dhanasiri, Sujith Eur J Haematol Original Articles OBJECTIVE: Autologous stem cell transplantation (ASCT) has improved progression‐free survival (PFS) and overall survival in eligible patients with newly diagnosed multiple myeloma (NDMM); however, relapse occurs. Maintenance therapy with lenalidomide (Len‐Mt) extends survival and delays relapse and the subsequent initiation of costly second‐line regimens. Here, we report the cost‐effectiveness of Len‐Mt following ASCT from a Dutch healthcare service perspective. METHODS: A partitioned survival model was developed to assess the lifetime costs and benefits for patients with NDMM. Efficacy was taken from a pooled meta‐analysis of clinical trial data. Costs and subsequent therapy data were taken from sources appropriate for the Dutch market. RESULTS: Lenalidomide produced a quality‐adjusted life year gain of 2.46 and a life year gain of 2.79 vs no maintenance treatment. The cost of lenalidomide was partially offset by savings of EUR 77 462 in subsequent treatment costs. The incremental cost‐effectiveness ratio of Len‐Mt vs no maintenance treatment was EUR 30 143. Key model drivers included subsequent therapies, dosing schedule, and time horizon. CONCLUSION: Lenalidomide is cost‐effective after ASCT vs no maintenance therapy in the Netherlands. By extending PFS, lenalidomide delays the cost burdens associated with relapse and subsequent treatment lines. John Wiley and Sons Inc. 2020-09-12 2020-11 /pmc/articles/PMC7590122/ /pubmed/32705720 http://dx.doi.org/10.1111/ejh.13497 Text en © 2020 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Uyl‐de Groot, Carin A.
Ramsden, Rachel
Lee, Dawn
Boersma, Janneke
Zweegman, Sonja
Dhanasiri, Sujith
Lenalidomide as maintenance treatment for patients with multiple myeloma after autologous stem cell transplantation: A pharmaco‐economic assessment
title Lenalidomide as maintenance treatment for patients with multiple myeloma after autologous stem cell transplantation: A pharmaco‐economic assessment
title_full Lenalidomide as maintenance treatment for patients with multiple myeloma after autologous stem cell transplantation: A pharmaco‐economic assessment
title_fullStr Lenalidomide as maintenance treatment for patients with multiple myeloma after autologous stem cell transplantation: A pharmaco‐economic assessment
title_full_unstemmed Lenalidomide as maintenance treatment for patients with multiple myeloma after autologous stem cell transplantation: A pharmaco‐economic assessment
title_short Lenalidomide as maintenance treatment for patients with multiple myeloma after autologous stem cell transplantation: A pharmaco‐economic assessment
title_sort lenalidomide as maintenance treatment for patients with multiple myeloma after autologous stem cell transplantation: a pharmaco‐economic assessment
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590122/
https://www.ncbi.nlm.nih.gov/pubmed/32705720
http://dx.doi.org/10.1111/ejh.13497
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