Clinical, Economic Burden of Corneal Adverse Events in MM Is Low Compared With Total All-Cause Costs

Although corneal adverse events (AEs) were observed in about 12% of patients with multiple myeloma (MM) treated with anticancer therapies, the clinical and economic burden of treating corneal AEs was low compared with total all-cause or MM-related per-patient-per-month (PPPM) costs, investigators concluded.

“As the current treatment landscape includes newer treatments, better understanding of these targeted treatments and their level of resource utilization is important. Therefore, further research and real-world evidence are warranted to assess the relationship between corneal AEs and MM treatment and to explore costs associated with specific treatments,” the investigators wrote.

In addition, the real-world retrospective cohort study, published in the Journal of Medical Economics, found that the majority of incident corneal AEs reported were mostly treated in outpatient care centers by ophthalmologists rather than by a hematologist or oncologist.

With increased use of novel anticancer therapies, adverse effects on patients’ eyes have become more common. However, given the novelty of many of these agents, oncologists may not be very familiar with the potential ophthalmologic AEs associated with targeted anticancer therapies. Knowing that AEs can affect patient quality of life and increase economic burden on the health care system, there remains a need to assess the incidence and extent of the burden of managing corneal AEs and related symptoms among patients receiving MM therapies.

The investigators collected information from the IQVIA PharMetrics Plus database, which contains adjudicated health insurance claims data from US commercial insurance plans. The evaluation period lasted between January 1, 2011, and December 31, 2017. Adults with newly diagnosed MM and adults with lymphatic or hematopoietic malignant neoplasm were included in the analysis. The index period, defined as the date that a patient first received a novel MM therapy, was from January 1, 2012, to December 31, 2016.

Within the index period, 2120 patients with MM and 26,923 patients with hematologic malignant neoplasm were identified and enrolled into the MM cohort and the hematology cohort.

Among the MM cohort, 248 (11.7%) patients had at least 1 incident of corneal AEs after initial onset of MM therapy. Also, 7.4% of the hematology cohort experienced at least 1 corneal AE after therapy onset. The most commonly reported corneal AEs in the MM cohort were dry eye (6.1%), keratopathy or keratitis (2.5%), blurred vision or decreased acuity (3.4%), and photophobia (0.2%).

For the patients with MM who reported a corneal AE, the overall median PPPM cost for a corneal AE was $27, representing less than 1% of the median all-cause costs during the follow-up period. The median total all-cause PPPM cost was $17,286 and the median MM-related PPPM cost was $13,851. The investigators noted that the costs were primarily driven by outpatient care, as most of the patients visited an outpatient facility for their AEs.

Emergency department visits, which cost a median PPPM of $66, and hospitalizations, which cost a median PPPM of $16, were rate. Reports for blurred vision and decreased acuity were associated with the highest PPPM cost compared with other corneal AEs, costing a median PPPM of $41.

The use of a 12-month washout period to identify newly treated patients, lack of generalizability to the general MM population or to patients with MM older than 65 years who are enrolled in Medicare, and lack of information on comorbidities were listed as study limitations. Additionally, there may be a potential underreporting of corneal AEs because older patients have a higher risk of dry eye syndrome.

Reference

Wang F, Sansbury L, Ferrante S, et al. Incidence of corneal adverse events in patients with multiple myeloma and their clinical and economic impact: a real-world retrospective cohort study. J Med Econ. 2022:25(1):182-192. doi:10.1080/13696998.2022.2029088