Cost-effectiveness of once-weekly selinexor, bortezomib, and dexamethasone in relapsed or refractory multiple myeloma

Abstract

The BOSTON trial showed that use of once-weekly selinexor, bortezomib, and dexamethasone (SVd) prolonged progression-free survival compared to twice-weekly bortezomib and dexamethasone (Vd) in patients with relapsed or refractory (R/R) multiple myeloma (MM). In this study, we constructed a Markov model to assess the cost-effectiveness of SVd versus Vd in R/R MM. We calculated the incremental cost-effectiveness ratio (ICER) of each treatment strategy from a US payer perspective, using a lifetime horizon and a willingness-to-pay threshold of $150,000 per quality-adjusted life-year (QALY). Use of SVd was associated with an incremental cost of $170,002 compared to Vd alone ($1,015,120 vs. $845,118, respectively), an incremental effectiveness of 0.35 QALYs (3.43 vs. 3.08 QALYs, respectively), and an ICER of $487,361/QALY. These data suggest that use of once-weekly SVd for R/R M/M is unlikely to be cost-effective compared to twice-weekly Vd.

Keywords:

• Selinexor
• cost-effectiveness
• myeloma

Disclosure statement

Patel, Parker, Di, Bar: no conflicts of interests to disclose. Huntington: consultant and honoraria for Bayer, Genentech, Pharmacyclics, AbbVie, BeiGene, Novartis, Johnson & Johnson, Seagen; research funding from DTRM Biopharm, Celgene, TG Therapeutics. Giri: research funding from Carevive, Packhealth.

Additional information

Funding

This work was supported by the American Society of Hematology Physician-Scientist Career Development Award; Frederick A. DeLuca Foundation.