Single agent daratumumab may serve as a more cost-effective treatment strategy than pomalidomide for patients with refractory multiple myeloma.
Treatment options were once scarce for multiple myeloma patients with refractory disease; however, the US Food and Drug Administration recently approved six new therapies for this disease setting. Little research has addressed the cost-effectiveness of each agent.
Researchers from Stanford Health Care (South Pasadena, CA) used clinical trial data to compare the cost-effectiveness of daratumumab vs pomalidomide for patients refractory to bortezomib and lenalidomide, using a willingness-to-pay threshold of $150,000 per quality-adjusted life-year (QALY). The analysis further focused on incremental cost-effectiveness ratios (ICERs) and net monetary benefits of daratumumab as compared with pomalidomide.
Daratumumab proved essentially cost-effective, with an ICER of $150,122 per QALY. One-way sensitivity analyses showed that the ICER remains consistent regardless of changes to parameter values, with overall survival and costs of post-progression therapy exhibiting the greatest level of sensitivity.
When using a willingness-to-pay threshold of $170,000 per QALY, the researchers found that daratumumab remained cost-effective more than 50% of the time, and that its net monetary benefits exceeded pomalidomide at willingness-to-pay thresholds of $150,000. – Cameron Kelsall