title: Economic burden of relapsed or refractory multiple myeloma: Results from an international trial.
abstract: OBJECTIVE
  The direct cost of relapsed or refractory multiple myeloma (RRMM) is documented; indirect costs are being explored. Healthcare payers seek cost-offsets from therapies that improve clinical outcomes but challenge budgets; employers seek lower absenteeism and better productivity. Study goals were to: (i) identify direct and indirect economic factors of RRMM, and (ii) explore longitudinal relationships between clinical, economic, and health-related quality of life (HRQoL) assessments.
  
  
  METHODS
  Economic questionnaire, clinical, and HRQoL data from a multisite, international, randomized, controlled study in RRMM were analyzed.
  
  
  RESULTS
  Patients (n=263) were 53.6% male, 91.6% Caucasian; mean age of 62.9 years, median Eastern Cooperative Oncology Group status of 1 (56.3%). Moderate to severe pain or fatigue was reported by 30.4% and 70.6%, respectively. At baseline, ≥1 hospitalization was reported by 107 (41.8%); 182 (71.1%) and 86 (33.6%) reported specialist and family physician visits, respectively. A total of 28 (10.8%) were working: 10 (37.0%) of which reported RRMM-driven absenteeism ≥1 day. Of those who were not working, 110 (48.2%) indicated that it was due to RRMM. Multivariate modeling showed lower hospitalization with a major tumor response (β=-1.44, CI: -2.89 to 0.01, P=.05).
  
  
  CONCLUSIONS
  Substantial RRMM indirect, social costs were observed. Better major tumor response may reduce hospital visits.
authors.affiliation: Janssen Global Services, Raritan, NJ, USA.
authors.forename: Don
authors.initials: D
authors.lastname: Robinson
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Robert Z
authors.initials: RZ
authors.lastname: Orlowski
authors.affiliation: Evidera, Montreal, QC, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Stokes
authors.affiliation: Janssen Global Services, Raritan, NJ, USA.
authors.forename: Jianming
authors.initials: J
authors.lastname: He
authors.affiliation: Evidera, Waltham, MA, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Huse
authors.affiliation: Evidera, Waltham, MA, USA.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Chitnis
authors.affiliation: Janssen Research and Development, Leiden, The Netherlands.
authors.forename: Britte
authors.initials: B
authors.lastname: Kranenburg
authors.affiliation: Janssen Global Services, Raritan, NJ, USA.
authors.forename: Annette
authors.initials: A
authors.lastname: Lam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000191:economics / Q000379:methods; D017281:Cost of Illness; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011788:Quality of Life; D012008:Recurrence; D018434:Sickness Impact Profile
chemical_list: D015415:Biomarkers
keywords: clinical trials; health-related quality of life; multiple myeloma