title: Double Relapsed and/or Refractory Multiple Myeloma: Clinical Outcomes and Real World Healthcare Costs.
abstract: Double relapsed and/or refractory multiple myeloma (DRMM), MM that is relapsed and/or refractory to bortezomib and lenalidomide, carries a poor prognosis. The healthcare costs of DRMM have not previously been reported. We analyzed detailed medical resource utilization (MRU) costs, drug costs and outcomes for 39 UK patients receiving standard DRMM therapy. Median OS in this cohort was 5.6 months. The mean cost of DRMM treatment plus MRU until death was £23,472 [range: £1,411-£90,262], split between drug costs £11,191 and other resource use costs £12,281. The cost per assumed quality-adjusted life year (QALY) during DRMM was £66,983. These data provide a standard of care comparison when evaluating the cost-effectiveness of new drugs in DRMM.
authors.affiliation: Department of Haematology, Oxford University Hospitals NHS Trust, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LE, United Kingdom; National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford, OX3 7LE, United Kingdom; MRC Human Immunology Unit, University of Oxford, Weatherall Institute of Molecular Medicine, Headley Way, Oxford, OX3 9DS, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Gooding
authors.affiliation: Department of Haematology, Oxford University Hospitals NHS Trust, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LE, United Kingdom; National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford, OX3 7LE, United Kingdom.
authors.forename: I-Jun
authors.initials: IJ
authors.lastname: Lau
authors.affiliation: Department of Haematology, Oxford University Hospitals NHS Trust, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LE, United Kingdom; National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford, OX3 7LE, United Kingdom; Department of Oncology, University of Oxford, Old Road Campus Research Building, Oxford University Old Road Campus, Oxford, OX3 7LH, United Kingdom.
authors.forename: Mimi
authors.initials: M
authors.lastname: Sheikh
authors.affiliation: Department of Haematology, Oxford University Hospitals NHS Trust, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LE, United Kingdom.
authors.forename: Pamela
authors.initials: P
authors.lastname: Roberts
authors.affiliation: Department of Haematology, Oxford University Hospitals NHS Trust, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LE, United Kingdom.
authors.forename: Julia
authors.initials: J
authors.lastname: Wong
authors.affiliation: Department of Haematology, Oxford University Hospitals NHS Trust, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LE, United Kingdom; National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford, OX3 7LE, United Kingdom.
authors.forename: Emmy
authors.initials: E
authors.lastname: Dickens
authors.affiliation: BresMed Health Solutions, 84 Queen Street, North Church House, Sheffield, S1 2DW, United Kingdom.
authors.forename: Ash
authors.initials: A
authors.lastname: Bullement
authors.affiliation: BresMed Health Solutions, 84 Queen Street, North Church House, Sheffield, S1 2DW, United Kingdom.
authors.forename: Jamie
authors.initials: J
authors.lastname: Elvidge
authors.affiliation: BresMed Health Solutions, 84 Queen Street, North Church House, Sheffield, S1 2DW, United Kingdom.
authors.forename: Dawn
authors.initials: D
authors.lastname: Lee
authors.affiliation: Department of Haematology, Oxford University Hospitals NHS Trust, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LE, United Kingdom; National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford, OX3 7LE, United Kingdom; Royal Berkshire Hospital NHS Trust, London Rd, Reading, RG1 5AN, United Kingdom.
authors.forename: Karthik
authors.initials: K
authors.lastname: Ramasamy
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D000069286:Bortezomib / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D012008:Recurrence; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D006113:United Kingdom
chemical_list: D000970:Antineoplastic Agents; D013792:Thalidomide; D000069286:Bortezomib; D000077269:Lenalidomide