High Economic Burden of MM, Particularly Within 1 Year of Diagnosis, Says French Study

A new French study is highlighting the high cost burden associated with multiple myeloma (MM), as well as variability in treatments used in later lines of therapy. The findings were published in The European Journal of Health Economics.

As more treatments continue to enter the market for MM, the cost of associated treatments is expected to continue climbing, with the researchers of the study emphasizing the need for more effective and options to help mitigate costs.

“Understanding patient [health care resource utilization] patterns, disease burden, and health-related expenditure is important when evaluating the potential value of new treatments and facilitates targeted improvements in MM management,” explained the researchers. “Analyses of health insurance databases can guide public health care decisions, monitor various types of medical expenditures, inform epidemiological studies, evaluate medical practices or health system experimentations, and can be used for international comparisons.”

The researchers included real-world data from 6400 patients diagnosed with MM between 2013 and 2018, finding an average annual cost of €58,300 (approximately $62,500). Notably, costs were highest in the first year after diagnosis, with a mean total annual cost per patient in the first exceeding €72,400 (approximately $77,600) and the monthly exceeding €7100 (approximately $7600).

The cost of treatment and hospitalizations contributed the most to costs, with an overall rate of 6.3 hospitalizations per patient per year. Nearly all (96.6%) patients underwent some type of hospitalization for any cause, and had at least 1 overnight hospital stay (93.1%). Notably, hospitalization accounted for a greater proportion (48.6%) of total costs in the first year after diagnosis than the average of the rest of the years of follow-up (38.1%).

With each line of therapy (LOT), the monthly costs associated with treatment increased. Monthly costs increased from €2447 (approximately $2600) during the first LOT to €7026 (approximately $7500) during fifth LOT and subsequently.

“Increase in hospitalisation costs associated with subsequent LOT was likely related to the increasing age and decreasing health of patients requiring ongoing treatment for MM,” described the researchers. “This is supported by a retrospective study of hospitalised French patients, which identified an association between age and duration of hospital stay. The cost of hospitalisations for an event of interest constituted a greater proportion of hospitalisation costs among patients at later LOT, indicating that declining patient condition conferred a greater burden to the health care system beyond the cost of drugs.”

Health care resource utilization was lower for patients who received stem cell transplantation, although their hospital stays were associated with higher costs, largely due to the more expensive procedure.

Nearly all (97.1%) patients received an identifiable treatment throughout the study period, with the most frequent regimens being those that included bortezomib. Bortezomib-based regimens accounted for 62.2% of the 8865 regimens, and 96.7% of patients received the combination as their first LOT. During second and third LOT, lenalidomide-based regimens were most common. By the fourth line of therapy and later, the researchers identified 37 different regimens.

Reference

Bessou A, Colin X, Nascimento J, et al. Assessing the treatment pattern, health care resource utilisation, and economic burden of multiple myeloma in France usingthe Système National des Données de Santé (SNDS) database:a retrospective cohort study. Eur J Health Econ. Published online May 25, 2022. doi:10.1007/s10198-022-01463-9