Cost-effectiveness analysis on binary/triple therapy on the basis of ixazomib or bortezomib for refractory or relapsed multiple myeloma

Abstract

This study analyzed the cost utility on the use of ixazomib/lenalidomide/dexamethasone (IRD), lenalidomide/dexamethasone (RD), bortezomib/thalidomide/dexamethasone (VTD), or bortezomib/dexamethasone (VD) for patients with refractory or relapsed multiple myeloma (rrMM). Patients’ lifelong direct medical costs and quality-adjusted life years (QALYs) are simulated by using the Markov model on the basis of the China’s healthcare system. VTD, RD, and IRD are 0.12, 0.32, and 0.42 QALYs higher than VD, and $9401, $16,868, and $39,671 higher than those of VD in terms of lifelong cost. The incremental cost-effectiveness ratios are 78,342, 52,713, and 94,455, respectively. IRD can extend the life years of patients with rrMM, improve the quality of life, and increase the cost of medical treatment. The use of VD has a comparative advantage of cost utility. For patients who cannot tolerate bortezomib or were drug-fast with first-line bortezomib, RD plan is another economical and effective strategy.

Keywords:

• Cost-effectiveness
• ixazomib
• bortezomib
• lenalidomide
• rrMM
• relapsed or refractory
• multiple myeloma

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/10.1080/10428194.2019.1620947.

Additional information

Funding

This study was supported by Fujian Provincial Department of Science & Technology of the People’s Republic of China (grant no. 2017Y0035) and National Natural Science Foundation of China [grant no. 71804025].