Millennium:
The Takeda Oncology Company today announced that two studies
presented at the 51st American Society of Hematology (ASH) Annual
Meeting found that VELCADE based regimens are more cost-effective for
payers and reduced out-of-pocket costs for patients than other commonly
used multiple myeloma treatments. The study found that
VELCADE-melphalan-prednisone (VMP), a commonly used treatment in
multiple myeloma, was more cost-effective compared to MP and delivered
more cost-savings compared to melphalan-prednisone-thalidomide (MPT),
another commonly used treatment regimen, based on a health economic
model.
A second study based on claims data found patients with multiple myeloma
treated with VELCADE:
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Incurred fewer out-of-pocket costs than patients treated with the oral
drugs thalidomide and lenalidomide
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Did not require significantly more healthcare visits than patients
prescribed thalidomide and lenalidomide.
“These studies support VELCADE’s overall cost-effectiveness and reduced
out-of-pocket costs. As measured by the number of healthcare visits,
VELCADE appears to be as convenient as oral multiple myeloma
treatments,” said Dixie-Lee Esseltine, M.D., Vice President, Global
Medical Affairs, Millennium. “This is valuable information for
healthcare providers, patients and payers.”
The Cost-Effectiveness of Bortezomib for the Initial Treatment of
Multiple Myeloma in the United States (Abstract #1379)
Based on a direct comparison of patient-level data,
researchers projected that VMP would be cost-effective over a patient’s
lifetime compared with MP in the United States. A second indirect
comparison across different trials projected the combination of VMP
would cost payers 17.7 percent less over a patient’s lifetime and
generate better quality-adjusted life expectancy than MPT.
Quality-adjusted life years are a measure of disease burden that take
into account both the length and quality of life.
The incremental cost-effectiveness of VMP versus MP was found to be
within the generally accepted cost-effectiveness range of
$50,000-$100,000 per quality-adjusted life year. The projected overall
survival years were greatest for patients treated with VMP versus those
treated with MPT or MP (4.19, 4.14, and 2.86 years, respectively).
“Cancer can be a costly disease for both payers and patients, and this
is certainly true in multiple myeloma,” said Professor Lou Garrison, a
study co-author and Associate Director in the Pharmaceutical Outcomes
Research and Policy Program, Department of Pharmacy, University of
Washington, Seattle. “It is therefore important to identify
cost-effective therapies. This trial-based modeling study demonstrates
that the first-line regimen using VELCADE is cost-effective compared to
other commonly used regimens.”
To assess the relative costs and outcomes of different treatment
combinations, study methodology generated modeling projections based on
a direct comparison from the Phase III VISTA trial, which
demonstrated superiority in overall survival of VMP versus MP (San
Miguel et al, New England Journal of Medicine 2008) for treatment
of multiple myeloma, as well as an indirect comparison of this trial
with data published from the IFM 99-06 clinical trial for MPT (Facon et
al, Lancet 2007). Costs included per-protocol drug and medical
costs, treatment-related adverse events, second-line treatment, and
resource utilization during treatment-free interval and progressive
disease. Unit costs of medications were obtained from published
literature.
Multiple Myeloma: Patient Out-Of-Pocket Costs and Health Care
Utilization (Abstract #1366)
In the second study, researchers used data from one of the largest U.S.
commercial healthcare plans to evaluate the number of healthcare visits
and out-of-pocket costs for multiple myeloma patients being treated with
various therapies. After adjusting for patient characteristics, line of
treatment, and co-morbidities by multivariate analysis, data showed that
patients receiving VELCADE did not have a significantly different number
of healthcare visits than those receiving lenalidomide or thalidomide,
two oral therapies. Additionally, direct out-of-pocket costs were found
to be significantly lower for patients treated with VELCADE than
patients treated with thalidomide or lenalidomide.
“There is a common perception that oral drugs are more convenient for
patients, but these data show that, in terms of healthcare visits, that
perception of convenience is false,” said study author Brett W. Pinsky,
i3 Innovus researcher. “These data are consistent with the fact that
patients with multiple myeloma typically require a great deal of care
and resource utilization; therefore, most patients will not see a major
difference in the number of healthcare visits regardless of whether
their treatment is oral or infusion – but they may face a significantly
higher out-of-pocket cost with oral medications.”
The total patient out-of-pocket costs for the year after treatment
initiation were significantly less for patients treated with VELCADE
($3,504) than for those treated with either of the oral drugs
thalidomide ($4,443, p<0.05) or lenalidomide ($4,766, p<0.05), after
adjusting for patient characteristics, line of treatment, and
co-morbidities by multivariate analysis. These differences were greatest
for Medicare patients, with the adjusted patient costs nearly two and
three times greater for thalidomide ($8,824) and lenalidomide ($12,568),
respectively, compared with VELCADE ($4,395).
The study is a retrospective cohort study, which used claims data from a
large national U.S. commercial health plan representing approximately 14
million members, and included a total of 2,642 treatment episodes for
the 1,900 multiple myeloma patients.
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