title: Cost of illness in patients with multiple myeloma in Italy: the CoMiM study.
abstract: OBJECTIVE
  Multiple myeloma is the second most common hematological cancer. Although it accounts for only a relatively small percentage of all cancer types, the costs associated with managing multiple myeloma are considerable. Available studies are mainly focused on health care costs. The Costo del Mieloma Multiplo (Cost of MM, CoMiM) study investigated the cost of illness of multiple myeloma in Italy during one year of disease management.
  
  
  METHODS
  CoMiM is a retrospective, prevalence-based, multi-center, cross-sectional study based on a stratified sample of patients seen during normal clinical practice (asymptomatic; symptomatic on drugs; symptomatic receiving autologous stem cell transplantation; plateau/remission). Demographics, clinical history, health care and non-health care resource consumption data were collected. Costs were evaluated from the societal viewpoint and expressed in Euro 2008.
  
  
  RESULTS
  Data on 236 patients were analyzed (39 asymptomatic, 17%; 29 symptomatic receiving autologous stem-cell transplantation, 12%; 105 symptomatic receiving drugs, 44%; 63 plateau/remission, 27%). The total cost of illness reached € 19,267.1 ± 25,078.6 (asymptomatic, € 959.3 ± 1091.6; symptomatic receiving drugs, € 21,707.8 ± 21,785.3; symptomatic receiving autologous stem-cell transplantation, € 59,243.7 ± 24,214.0; plateau/remission, € 8130.7 ± 15,092.5). The main cost drivers of total cost of illness were drugs and hospital admissions (46.1% and 29.4%, respectively). Antineoplastics and immunomodulators drove the cost of drugs (21.6% and 21.1% of the total cost of illness). Cost of antineoplastics was led by bortezomib (97.4%), whereas the cost driver for immunomodulators was lenalidomide (99.4%). Cost of hospitalization funded by the Italian National Health Service was strongly influenced by transplantation (94.6%), whereas chemotherapy and skeletal fractures did not exceed 1% and 2%, respectively.
  
  
  CONCLUSIONS
  Despite some limitations, the CoMiM study provides Italian health care decision-makers with an insight into the stratified cost of illness of multiple myeloma patients.
authors: Maria Teresa
authors: MT
authors: Petrucci
authors: Elisabetta
authors: E
authors: Calabrese
authors: Anna
authors: A
authors: Levi
authors: Vincenzo
authors: V
authors: Federico
authors: Michela
authors: M
authors: Ceccolini
authors: Rita
authors: R
authors: Rizzi
authors: Alessandro
authors: A
authors: Gozzetti
authors: Patrizia
authors: P
authors: Falco
authors: Carlo
authors: C
authors: Lazzaro
authors: Elisa
authors: E
authors: Martelli
authors: Mario
authors: M
authors: Boccadoro
authors: Francesco
authors: F
authors: Lauria
authors: Vincenzo
authors: V
authors: Liso
authors: Michele
authors: M
authors: Cavo
authors: Robert
authors: R
authors: Foa
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000191:economics* / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000191:economics*; D014182:Transplantation, Autologous
chemical_list: D000970:Antineoplastic Agents