https://orcid.org/0000-0001-5537-6767
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Abstract
Aim: To estimate current real-world costs of drugs and supportive care for the treatment of multiple myeloma in a tax-based health system. Methods: Forty-one patients were included from a personalized medicine study (2016–2019). Detailed information was collected from patient journals and hospital registries to estimate the total and mean costs using inverse probability weighting of censored data. Results: Total observed (censored) costs for the 41 patients was €8.84 million during 125 treatment years, with antineoplastic drugs as the main cost driver (€5.6 million). Individual costs showed large variations. Mean 3-year cost per patient from first progression was €182,103 (€131,800–232,405). Conclusion: Prediction of real-world costs is hindered by the availability of detailed costing data. Micro-costing analyses are needed for budgeting and real-world evaluation of cost-effectiveness.
Lay abstract
In recent years, there has been a dramatic improvement in the treatment of multiple myeloma due to the introduction of new drugs. These drugs have significantly increased survival but have also had an immense impact on healthcare budgets. In this study, we used detailed treatment information for multiple myeloma patients in combination with billing data from the hospital pharmacy at a Danish hospital to calculate individual cost histories for both drugs and supportive care. Using these data, we estimated the mean 3-year cost of a multiple myeloma patient to be €182.103, but we also found large variation between patients, causing an uncertainty of €50.000 in either direction. We believe that detailed costing studies, similar to the present one, are necessary for evaluation of cost-effectiveness of drugs in clinical practice.
Supplementary data
To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/fon-2021-0189
Acknowledgments
The authors thank Susanne Storm Madsen, the Hospital Pharmacy, North Denmark Region, for assistance with data export and insight in billing data.
Author contributions
The study was conceptualized by M Bøgsted, AS Roug, RF Brøndum, AS Vestergaard and LH Ehlers. Patient recruitment and data collection were designed by H Gregersen, MT Severinsen, M Bøgsted, C Vesteghem, AS Roug, AS Rytter, RF Brøndum and TC El-Galaly. Clinical protocol design and patient inclusion by P Jensen, AS Roug, MT Severinsen, K Dybkær, TC El-Galaly and M Bøgsted. Data collection from medical journals was done by AS Rytter and MM Nielsen. Data analysis and visualizations were done by RF Brøndum and L Børty. The manuscript was drafted by M Bøgsted, RF Brøndum and AS Roug. All authors critically reviewed and approved the final manuscript.
Financial & competing interests disclosure
This research was funded by the Danish Cancer Society and Aalborg University Hospital. TC El-Galaly is employed by Roche Ltd, Basel. AS Roug: Travel and conference fees (Daiichi Sankyo). MT Severinsen: principal investigator on clinical trials at the Department of Hematology sponsored by Celgene (AG221/IDHENTIFY), Astex Pharmaceuticals (Astral SGI-110), AbbVie (M15–656) and Sierra Oncology (MOMENTUM and SRA-MMB-4365). P Jensen: principal investigator on clinical trials at the Department of Hematology sponsored by Incyte (INCB 50465-203/Citadel-203) and (INCB 50465-205/Citadel 205). 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 article apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.
Ethical conduct of research
The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.
Data sharing statement
Due to the patient sensitive nature of the data, and confidentiality clauses on prices of medicine, they are not freely available, but reasonable requests may be made by email to the corresponding author.