Belantamab mafodotin for the treatment of relapsed/refractory multiple myeloma in heavily pretreated patients: a US cost-effectiveness analysis

ABSTRACT

Background

Patients with relapsed/refractory multiple myeloma (RRMM) require several lines of therapy, with typically shorter remission duration with each additional line.

Research design and methods

The cost-effectiveness of belantamab mafodotin (belamaf; DREAMM-2; NCT03525678) was compared with selinexor plus dexamethasone (SEL+DEX; STORM Part 2; NCT02336815) among patients with RRMM who have received at least four prior therapies. The base case used a US commercial payer’s perspective over a 10-year time horizon. Efficacy data were based on parametric survival analysis of DREAMM-2 and matching-adjusted indirect treatment comparison between DREAMM-2 and STORM Part 2, which assessed relative treatment effects between belamaf and SEL+DEX. Cost inputs included drug treatment, concomitant medications, adverse event management, subsequent treatments, and disease management.

Results

Belamaf decreased total treatment costs per patient by $14,267 and increased patient life years by 0.74 and quality-adjusted life years (QALYs) by 0.49 versus SEL+DEX. Patients receiving belamaf accrued 0.12 fewer progression-free life years versus patients on SEL+DEX.

Conclusions

From a US commercial payer’s perspective, belamaf had lower costs, and increased QALYs and life-year gain, compared with SEL+DEX. Belamaf is therefore likely to be a cost-effective treatment option for patients with RRMM who have received four or more prior lines of therapy.

KEYWORDS:

• Cost-effectiveness
• efficacy
• HRQoL
• modeling
• RRMM
• safety

Acknowledgments

The authors would like to thank Gene Felber for his contributions to conceptualization of the initial study design.

Author contributions

A Nikolaou, A Shah, W Ma, V Kapetanakis, and J Willson were involved in the conception or design of the study and data acquisition, analysis, and interpretation. A Ambavane was involved in the conception and design of the study and acquisition of data. J Tosh was involved in data acquisition, analysis, and interpretation. F Wang, C Hogea, B Gorsh, B Gutierrez, S Sapra, and Y Samyshkin were involved in the conception or design of the study and data analysis and interpretation. A Suvannasankha was involved in data analysis and interpretation. All authors were involved in the drafting of the paper, revising it critically for intellectual content, and the final approval of the version to be published, and agree to be accountable for all aspects of the work.

Declaration of interest

A Nikolaou, A Ambavane, A Shah, W Ma, J Tosh and V Kapetanakis are employees of Evidera who received research funding from GSK. J Willson, F Wang, B Gorsh, B Gutierrez, S Sapra and Y Samyshkin are employees of and have stocks and shares in GSK. A Suvannasankha has received consulting fees from GSK, Janssen, and Karyopharm Therapeutics; research funding from Bristol-Myers Squibb, Celgene, GSK, and Janssen; personal fees from GSK and Janssen; and is supported by the Veterans Affair merit award (BX004514). C Hogea was an employee of GSK at the time this analysis was conducted.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Data sharing statement

GSK makes available anonymized individual participant data and associated documents from interventional clinical studies which evaluate medicines, upon approval of proposals submitted to www.clinicalstudydatarequest.com. To access data for other types of GSK sponsored research, for study documents without patient-level data and for clinical studies not listed, please submit an enquiry via the website.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Clinical trial registration

www.clinicaltrials.gov identifiers are NCT03525678 and NCT02336815

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This study was funded by GlaxoSmithKline (GSK; 207155). GSK contributed to the study design, implementation, data collection, interpretation, and analysis. Medical writing support was provided by Muchaala Yeboah, PhD, and Sharon Bryant, DPT, of Fishawack Indicia, Ltd., part of Fishawack Health, and funded by GSK.