Budget Impact of Belantamab Mafodotin (Belamaf) Adoption in the Treatment of Patients with Relapsed or Refractory Multiple Myeloma in the United States

Anshul Shah; Jonathan C Tosh; Apoorva Ambavane; Andreas Nikolaou; Cosmina Hogea; Yevgeniy Samyshkin; Boris Gorsh; Eric M Maiese; Feng Wang

doi:10.2147/CEOR.S310619

Budget Impact of Belantamab Mafodotin (Belamaf) Adoption in the Treatment of Patients with Relapsed or Refractory Multiple Myeloma in the United States

Clinicoecon Outcomes Res. 2021 Sep 10:13:789-800. doi: 10.2147/CEOR.S310619. eCollection 2021.

Authors

Anshul Shah¹, Jonathan C Tosh², Apoorva Ambavane², Andreas Nikolaou², Cosmina Hogea³, Yevgeniy Samyshkin⁴, Boris Gorsh³, Eric M Maiese⁵, Feng Wang³

Affiliations

¹ Modelling and Simulation, Evidera, Waltham, MA, USA.
² Modelling and Simulation, Evidera, London, UK.
³ Value Evidence and Outcomes, GlaxoSmithKline, Upper Providence, PA, USA.
⁴ Value Evidence and Outcomes, GlaxoSmithKline, Brentford, UK.
⁵ Value Evidence and Outcomes, GlaxoSmithKline, Philadelphia, PA, USA.

Abstract

Purpose: Estimate the budget impact of belantamab mafodotin (belamaf) for patients with relapsed/refractory multiple myeloma (RRMM) who have received ≥4 prior therapies, including an anti-CD38 monoclonal antibody, a proteasome inhibitor, and an immunomodulatory agent.

Methods: A budget impact analysis (BIA) was developed to estimate the cost difference between current (no belamaf) and projected (with belamaf) market scenarios over 3 years. Comparators were identified from a systematic literature review and included selinexor + dexamethasone or best supportive care. The number of treatment-eligible patients were estimated using an epidemiology model. Base-case analyses were conducted from a US commercial payer perspective (cost year: 2019). Model inputs included market share estimates, treatment duration, and costs of drug acquisition/administration, concomitant medications, adverse event (AE) management, treatment monitoring, and subsequent treatments based on published literature/cost databases. Budget impact, calculated as the difference in costs between current and projected scenarios over 3 years, was reported as cost per member per month (PMPM) and per member per year (PMPY). One-way sensitivity analysis assessed which key parameters most affected model outcomes. Alternative scenarios were tested (1- or 5-year time horizon; Medicare perspective; negligible cost of mental status change AE).

Results: In a hypothetical commercial payer health plan with 1 million members, 33 patients were identified as treatment-eligible over 3 years. Introducing belamaf for patients with RRMM resulted in an estimated budget-neutral PMPM cost of -$0.0003 and PMPY of -$0.004, based on n=9/33 patients receiving treatment. Sensitivity analyses showed that budget impact in the base case was most sensitive to changes in treatment duration and drug acquisition costs. Base-case results were consistent across all scenarios assessed.

Conclusion: BIA indicates that adoption of belamaf in this patient population would be budget neutral for a US health plan.

Keywords: BCMA; belamaf; budget impact analysis; multiple myeloma; payer; relapsed/refractory.