title: Pharmacoeconomic implications of lenalidomide maintenance therapy in multiple myeloma.
abstract: We compared the three arms of the MM-015 randomized phase III clinical trial [melphalan and prednisone (MP), MP plus lenalidomide (MPR), and MPR plus lenalidomide maintenance (MPR-R)] to determine whether the addition of lenalidomide maintenance therapy for primary treatment of multiple myeloma is cost-effective. We used progression-free survival and adverse event data from the MM-015 study for the analysis. Two novel measures of cost-effectiveness termed the Average Cumulative Cost per Patient (ACCP) and the Average Cumulative Cost per Progression-Free Survivor (ACCPFS) were developed for the purpose of this analysis. The ACCP of MP was USD 18,218, compared to USD 167,862 for MPR and USD 309,173 for MPR-R. The ACCPFS was highest with MPR at USD 1,555,443, while MP was USD 313,592 and MPR-R was USD 690,111. MPR-R is superior to MPR in terms of preventing the first progression after initial therapy. However, the addition of lenalidomide to MP in the induction and also in the maintenance setting leads to significant costs.
authors: Division of Hematology, University of Southern California, Los Angeles, Calif., USA.
authors: Miriam Y
authors: MY
authors: Kim
authors: Richard
authors: R
authors: Sposto
authors: Abhisek
authors: A
authors: Swaika
authors: Hitomi
authors: H
authors: Asano
authors: Ahsan
authors: A
authors: Alamgir
authors: Asher
authors: A
authors: Chanan-Khan
authors: Sikander
authors: S
authors: Ailawadhi
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000191:economics*; D003362:Cost-Benefit Analysis; D018572:Disease-Free Survival; D017850:Economics, Pharmaceutical; D006801:Humans; D060828:Induction Chemotherapy; D000077269:Lenalidomide; D060046:Maintenance Chemotherapy; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000191:economics*; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics
chemical_list: D000970:Antineoplastic Agents; D013792:Thalidomide; D000077269:Lenalidomide; D008558:Melphalan; D011241:Prednisone