Economic burden of relapsed or refractory multiple myeloma: Results from an international trial

Eur J Haematol. 2017 Aug;99(2):119-132. doi: 10.1111/ejh.12876. Epub 2017 May 11.

Abstract

Objective: The direct cost of relapsed or refractory multiple myeloma (RRMM) is documented; indirect costs are being explored. Healthcare payers seek cost-offsets from therapies that improve clinical outcomes but challenge budgets; employers seek lower absenteeism and better productivity. Study goals were to: (i) identify direct and indirect economic factors of RRMM, and (ii) explore longitudinal relationships between clinical, economic, and health-related quality of life (HRQoL) assessments.

Methods: Economic questionnaire, clinical, and HRQoL data from a multisite, international, randomized, controlled study in RRMM were analyzed.

Results: Patients (n=263) were 53.6% male, 91.6% Caucasian; mean age of 62.9 years, median Eastern Cooperative Oncology Group status of 1 (56.3%). Moderate to severe pain or fatigue was reported by 30.4% and 70.6%, respectively. At baseline, ≥1 hospitalization was reported by 107 (41.8%); 182 (71.1%) and 86 (33.6%) reported specialist and family physician visits, respectively. A total of 28 (10.8%) were working: 10 (37.0%) of which reported RRMM-driven absenteeism ≥1 day. Of those who were not working, 110 (48.2%) indicated that it was due to RRMM. Multivariate modeling showed lower hospitalization with a major tumor response (β=-1.44, CI: -2.89 to 0.01, P=.05).

Conclusions: Substantial RRMM indirect, social costs were observed. Better major tumor response may reduce hospital visits.

Keywords: clinical trials; health-related quality of life; multiple myeloma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers
  • Combined Modality Therapy / adverse effects
  • Combined Modality Therapy / economics
  • Combined Modality Therapy / methods
  • Cost of Illness*
  • Drug Resistance, Neoplasm
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / epidemiology*
  • Multiple Myeloma / therapy
  • Quality of Life
  • Recurrence
  • Sickness Impact Profile

Substances

  • Biomarkers