Limited real-world evidence is available to describe the recent trends in multiple myeloma (MM) treatment costs and outcomes. This study assessed trends in novel therapy use, total healthcare costs, and survival outcomes among newly diagnosed MM patients in the United States since 2000. Novel agents approved for use in 2015 were not included in the analysis.
Patients aged ≥18 years with 2 or more medical claims with MM between January 2000 and September 2015 were identified in administrative claims databases. The date of the first medical claim for MM was designated as the index date. Controls were selected from a pool of patients without MM and matched 1:1 with MM patients on index year, age, sex, and geographic region. Total healthcare costs were defined as the sum of health plan– and patient-paid costs for inpatient admissions, outpatient services, and outpatient prescriptions. MM treatment-related drug costs included outpatient prescription costs and infusion costs from medical services associated with MM treatment.
After exclusions, 18,260 patients were matched to controls. The percentage of MM patients using novel therapies (pomalidomide, carfilzomib, bortezomib, lenalidomide, or thalidomide) continuously increased from 8.7% in 2000 to 61.3% in 2014. Total per-patient per-month all-cause healthcare costs increased from $3,263 in 2000 to $14,656 in 2014 among newly diagnosed MM patients, which were primarily driven by costs of outpatient services. Hospitalization costs accounted for 21.5% of total costs in 2000, which increased to 32.7% in 2014. MM treatment-related drug costs accounted for 10.6% of total costs in 2000, 23.6% in 2009, and 28.5% in 2014.
Patients diagnosed with MM after 2010 had significantly higher rates of novel therapy use and significantly better survival outcomes than patients diagnosed earlier. In fact, patients diagnosed in 2012 were 1.25 times more likely to survive 2 years than patients diagnosed in 2006. MM patients also showed improved survival outcomes over the study period, with the 2-year survival gap between MM patients and their matched controls decreasing at a rate of 3% per year.
These findings align with clinical data, suggesting that the rise of novel MM treatment options over the past 15 years have led to substantial survival gains. Although total healthcare costs among newly diagnosed MM patients have increased steadily since 2000 due to increases in all healthcare cost categories, the relative contribution of drug costs has remained fairly stable since 2009 despite new novel therapies coming to market in this time period.
Fonseca R, et al. ASH 2016. Abstract 3558.