Lenalidomide maintenance post-transplantation in newly diagnosed multiple myeloma: real-world outcomes and costs

Future Oncol. 2019 Dec;15(35):4045-4056. doi: 10.2217/fon-2019-0422. Epub 2019 Oct 18.

Abstract

Aim: To compare real-world outcomes and costs among patients with newly diagnosed multiple myeloma receiving lenalidomide-only maintenance (Len-Mt) versus no maintenance after autologous hematopoietic stem cell transplantation. Patients & methods: Time to next treatment (TTNT) was evaluated; costs were calculated for 0-12, 12-24 and 24-36 months postindex date. Results: Len-Mt cohort had longer TTNT (HR: 0.43; p < 0.0001). Per-patient per-month costs during months 0-12 were higher among patients, receiving Len-Mt (USD 13,095 vs USD 8910; p < 0.0001), due to higher pharmacy costs - outpatient costs were lower. During months 12-24 and 24-36, outpatient costs were similar in both cohorts; total and pharmacy costs remained elevated for patients receiving Len-Mt. Conclusion: Len-Mt improved TTNT, initially reduced outpatient costs, but resulted in higher overall and pharmacy costs.

Keywords: ASCT; autologous hematopoietic stem cell transplantation; healthcare resource utilization; lenalidomide; maintenance therapy; multiple myeloma; real world.

MeSH terms

  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Costs and Cost Analysis
  • Female
  • Health Care Costs
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Hematopoietic Stem Cell Transplantation / methods
  • Humans
  • Kaplan-Meier Estimate
  • Lenalidomide / administration & dosage
  • Lenalidomide / adverse effects
  • Lenalidomide / therapeutic use*
  • Maintenance Chemotherapy / economics
  • Maintenance Chemotherapy / methods
  • Male
  • Middle Aged
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / mortality
  • Postoperative Care
  • Retreatment
  • Retrospective Studies
  • Transplantation, Autologous
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Lenalidomide