Despite advances in the treatment of multiple myeloma (MM), there is an ongoing need for new agents that can provide durable disease control in patients with relapsed/refractory MM (RRMM). In 2015, elotuzumab, in combination with lenalidomide and dexamethasone (ELd), received approval for the treatment of patients with MM who have received 1 to 3 prior therapies. As combination therapies for MM become more widely adopted in the clinical treatment setting, US payers may have concern about the costs of these therapies.
In an effort to address these potential concerns, a budget impact model was developed to estimate the 3-year costs of adding ELd to a health plan’s formulary. Treatment regimens approved for use in the United States as of November 2015 were included as comparators. The number of patients under treatment each year was based on treatment starts with the regimen, progression-free survival, and duration of treatment. In years 1, 2, and 3, ELd was projected to have a share of 9.7%, 8.9%, and 9.6% of patients with emergent RRMM, respectively. The model included adjusted costs related to the cost of administration, concomitant medications, adverse event management, laboratory tests, and disease monitoring. In the second and third years, costs incurred by incident patients of the previous years were also evaluated.
Modeled data outputs show that for a hypothetical plan of 1 million members, 29 patients with RRMM received treatment in year 1, 70 in year 2, and 96 in year 3. Without ELd, total costs increased from $7.1 million in the first year to $20.5 million in the third year, while total costs with elotuzumab added to lenalidomide and dexamethasone increased from $7.5 million in the first year to $21.7 million in the third year. Extrapolating to plan membership, the per-member per-month budget impact was $0.032 in the first year, increasing to $0.107 in the third year.
Based on this evaluation, researchers concluded that the introduction of ELd should only have a gradual and marginal budget impact on US health plans.
Potluri R, et al. ASH 2016. Abstract 2363.