Real-world outcome and healthcare costs of relapsed or refractory multiple myeloma: A retrospective analysis from the Chinese experience

Figures & data

Table 1 Patients’ characteristics at start of relapsed/refractory treatment

Characteristics	Total (n = 93)	%	Bortezomib (n = 36)	%	Non-bortezomib (n = 57)	%	P value*
Median age (years), range	65 (40–79)		64 (40–79)		65 (46–78)		0.702
Male/female	51/42	55/45	20/16	56/44	31/26	54/46	0.887
Myeloma type							0.014
IgG/IgA	47/29	51/31	16/15	44/41	31/14	54/25
IgM/IgD	1/1	1/1	1/1	3/3	0/0	0/0
Non-secretory/light chain	5/10	5/11	1/2	3/6	4/8	7/14
Stage (Salmon and Durie)							0.452
IIA/IIB	13/3	14/3	4/1	11/3	9/2	16/4
IIIA/IIIB	48/29	52/31	21/10	58/28	27/19	47/33
WHO performance status
<2/≥2	66/27	73/27	29/7	81/19	37/20	65/35	0.017
Best response to first-line treatment							0.931
Complete response	26	28	10	28	16	28
Very good partial response	17	18	7	19	10	18
Partial response	46	49	17	47	29	51
Median months from diagnosis to RRMM, range	20 (3–65)		18 (3–65)		22 (3–62)		0.167

WHO, World Health Organization; RRMM: relapsed/refractory multiple myeloma.

*The differences between bortezomib group and non-bortezomib group were analyzed using Pearson's χ² test and Mann–Whitney test.

Table 2 Unit costs of drugs and treatments received by treatment line (USD 2012)

			All 93 patients
Drugs	Unit	Price	Line 2 (n = 93)	Line 3 (n = 37)	Line 4 (n = 16)
Bortezomib	3.5 mg	2160	26	22	9
Thalidomide	25 mg	0.39	24	16	3
Lenalidomide	10 mg	349.75	1	3	1
Pegylated liposomal doxorubicin (PLD)	20 mg	785.74	15	8	5
Melphalan	2 mg	1.27	29	14	4
Doxorubicin	10 mg	26.46	52	12	6
Vincristine	1 mg	1.03	63	19	10
Cyclophosphamide	200 mg	5.13	40	14	5
Dexamethasone	5 mg	0.02	82	37	14
Etoposide	100 mg	2.52	16	5	3
Cisplatin	30 mg	4.13	16	5	3
Prednisone	5 mg	0.01	28	8	4
Mitoxantrone	2 mg	3.71	3	3	3
Interferon alpha	300 IU	21.07	2	0	0

Table 3 Mean monthly costs during relapsed/refractory treatment

	2nd line (n = 93)		3rd line (n = 37)		4th line (n = 16)		All lines (n = 93)*		Bortezomib (n = 36)*		Non-bortezmib (n = 57)*
Costs (USD 2012)	Mean	SD	Mean	SD	Mean	SD	Mean	SD	Mean	SD	Mean	SD	P value
Hospital stays	19.62	9.68	29.21	20.08	28.76	11.1	20.15	9.79	22.61	8.31	18.59	10.39	0.006
Drugs	562.14	696.52	1942	3569.46	2053.48	1968.64	746.32	967.71	1534.42	1171.78	248.58	169.84	<0.001
Laboratory tests	110.11	56.65	141.73	78.30	166.7	65.84	111.45	51.13	118.82	49.81	106.8	51.84	0.39
Diagnostic procedures	13.07	14.24	26.95	38.91	27.85	25.27	15.23	15.96	17.62	19.39	13.72	13.33	0.326
Concomitant treatment	196.84	259.15	379.01	370.26	446.64	376.17	228.78	250.49	337.04	318.83	160.4	165.08	<0.001
Hospital visit	2.87	2.76	1.46	1.84	2.15	3.26	3.27	5.26	2.28	2.38	3.83	6.43	0.25
Allogeneic-CIK cells infusions	0	0	117.74	499.34	0	0	24.67	136.78	63.72	215.91	0	0	NA
Total monthly costs	904.64	844.42	2638.11	3650.22	2725.58	2194.3	1139.85	1098.26	2071.96	1241.38	551.14	327.32	<0.001

CIK: cytokine-induced killer; SD: standard deviation; NA: not applicable because no costs were consumed.

*These costs are calculated per month over the patient's entire follow-up.

Table 4 Mean monthly costs during each line treatment with bortezomib

	2nd line (n = 93)					3rd line (n = 37)					4th line (n = 16)
	Bortezomib (n = 25)		Non-bortezomib (n = 68)			Bortezomib (n = 22)		Non-bortezomib (n = 15)			Bortezomib (n = 9)		Non-bortezomib (n = 7)
Costs (USD 2012)	Mean	SD	Mean	SD	P	Mean	SD	Mean	SD	P	Mean	SD	Mean	SD	P
Hospital stays	19.65	8.31	19.61	10.20	0.706	28.12	19.23	30.81	21.85	0.867	29.12	11.33	28.30	11.66	0.94
Drugs	1467.04	801.11	229.46	135.65	<0.001	3000.67	4334.76	389.29	482.75	<0.001	3351.14	1711.16	385.06	105.56	<0.001
Laboratory tests	103.42	56.20	112.57	57.03	0.260	143.57	81.10	139.04	76.73	0.703	190.04	69.58	136.68	50.13	0.114
Diagnostic procedures	13.61	15.16	12.87	13.99	0.937	34.58	46.94	15.77	19.05	0.457	26.18	25.04	30	27.41	0.782
Concomitant treatment	356.91	397.43	137.99	150.19	0.002	397.69	384.70	351.60	351.49	0.636	616.15	431.21	228.83	86.22	0.005
Hospital visit	3.13	2.69	2.77	2.80	0.533	1.22	1.60	1.82	2.14	0.51	2.67	3.55	1.47	2.98	0.343
Allogeneic-CIK cells infusions	0	0	0	0	NA	198.02	640.93	0	0	NA	0	0	0	0	NA
Total monthly costs	1963.76	1280.90	515.26	369.87	<0.001	3803.87	4347.02	928.23	805.89	<0.001	4215.2	1815.77	810.35	182.93	<0.001

CIK: cytokine-induced killer; SD: standard deviation; NA: not applicable because no costs were consumed.

Figure 1 Overall survival curves from start of relapsed/refractory treatment stratified by treatment with bortezomib.