Rebecca Araujo

DocwireNews

First-line daratumumab therapy for patients with transplant-ineligible multiple myeloma (MM) may not be cost-effective at the drug&rsquo;s current price, according to a new study.Daratumumab is an anti-CD38 monoclonal antibody approved for the treatment of MM. Previous studies have shown that the addition of daratumumab to the combination of lenalidomide and dexamethasone (DRd) significantly prolonged progression-free survival (PFS) in newly diagnosed patients. However, daratumumab is infused indefinitely until disease progression, so at a cost of more than $6,000 per infusion, its value in a clinical setting may be limited.For this study, researchers from the Yale University School of Medicine and the University of Alabama sought to measure the <a href="https://www.docwirenews.com/hematology-oncology/is-cost-to-blame-for-racial-disparities-in-multiple-myeloma-treatment/" target="_blank" rel="noopener noreferrer">cost-effectiveness</a> of daratumumab as a first-line therapy for transplant-ineligible patients compared with reserving its use for a second-line regimen.To assess this, the team used a Markov model to compare healthcare costs and clinical outcomes of patients treated with first- versus second-line daratumumab. They calculated lifetime direct healthcare costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERS) for these two patient groups.The data showed that first-line daratumumab led to an improvement of 0.52 QALYs and 0.66 discounted life-years compared with second-line therapy. Both treatment strategies were associated with high lifetime costs: $1,434,937 vs. $1,112,101 US dollars for first- and second-line, respectively. At a willingness-to-pay threshold of $150,000 per QALY, the cost of first-line daratumumab would need to be 67% lower to be cost-effective.In conclusion, the researchers wrote, &ldquo;Delaying daratumumab until subsequent lines of therapy may be a reasonable strategy to limit healthcare costs without significantly compromising clinical outcomes. Mature overall survival data are necessary to more fully evaluate cost-effectiveness in this setting.&rdquo;This <a href="https://ascopubs.org/doi/full/10.1200/JCO.20.01849?utm_medium=cpc&amp;utm_campaign=J_Clin_Oncol_TrendMD_0&amp;utm_source=TrendMD">study</a> was published in the Journal of Clinical Oncology.<blockquote class="twitter-tweet">
Hot off the press in JCO, cost effectiveness of frontline Daratumumab among older adults with MM. ICER $618,018 per QALY. Time for value based pricing in the US? Work led by MS3 Kishan Patel, <a href="https://twitter.com/sfhYALE?ref_src=twsrc%5Etfw">@sfhYALE</a> <a href="https://twitter.com/DiMengyang?ref_src=twsrc%5Etfw">@DiMengyang</a> <a href="https://t.co/xh3Nc9hvb1">https://t.co/xh3Nc9hvb1</a>
&mdash; Smith Giri MD MHS (@smith__giri) <a href="https://twitter.com/smith__giri/status/1347560281933815809?ref_src=twsrc%5Etfw">January 8, 2021</a>
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Does Cost Limit the Value of First-Line Daratumumab For Myeloma?

Oncology

First-line daratumumab therapy for patients with transplant-ineligible multiple myeloma (MM) may not be cost-effective at the drug’s current price, according to a new ...

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