ECONOMIC EVALUATION OF CARFILZOMIB+LENALIDOMIDE+DEXAMETHASONE (KRD) VS. LENALIDOMIDE+DEXAMETHASONE (RD) IN RELAPSED OR REFRACTORY MULTIPLE MYELOMA (R/RMM)
(Abstract release date: 05/19/16)
EHA Library. Panjabi S. 06/09/16; 132822; E1273
Ms. Sumeet Panjabi
Contributions
Contributions
Abstract
Abstract: E1273
Type: Eposter Presentation
Background
In ASPIRE, KRd achieved superior progression free survival (PFS) (HR = 0.69; p = 0.0001) and improved quality of life (QoL) (p < 0.001) over Rd in patients (pts) with R/RMM.
Aims
We assessed the cost-effectiveness (CE) of KRd vs Rd from a US payer perspective with data from ASPIRE and long-term overall survival (OS) data from the Surveillance, Epidemiology, and End Results Program (SEER).
Methods
A partitioned-survival model with progression-free (PF), post-progression (PP) and death states was built with a 30 year horizon. Treatment (Tx) effect for PFS and OS was estimated with parametric regression models and applied over the time horizon. Since 60% of pre-specified OS events were observed, post-trial OS transition probabilities were estimated by matching SEER data to ASPIRE pts. Grade ≥ 3 adverse events (AEs) with > 2% incidence in any ASPIRE arm were included. Utilities were derived from literature and adjusted for the relative improvement in QoL increase observed when pts were PF in ASPIRE. Costs related to drug (WAC prices) as well as wastage (30% for carfilzomib), administration, monitoring, AE management, and subsequent Tx were considered. Tx duration was derived fitting ASPIRE data and carfilzomib was dosed up to 18 cycles. The base case assessed the CE of adding carfilzomib to Rd, and considered only additional costs of carfilzomib, i.e. neglecting Rd drug costs in both arms. A scenario including Rd costs in both arms was conducted. A 3% discount rate was applied to costs and outcomes.
Results
KRd was more effective compared to Rd, providing 1.134 PF life year, 1.927 life year, and 1.616 quality-adjusted life year (QALY) gains over the modelled horizon. KRd incurred $123,524 in total additional costs. Incremental CE ratio (ICER) was $76,416/QALY. With the inclusion of Rd costs, KRd incurred $179,863 additional costs with an ICER of $111,270/QALY.
Conclusion
The model predicts that KRd delivers nearly 2.86 additional undiscounted life year’s over the standard of care (Rd), and is cost-effective vs. Rd at a willingness-to-pay threshold of $120,000/QALY. Therefore, carfilzomib when added to Rd delivers considerable incremental value to patients and payers.
Session topic: E-poster
Keyword(s): Cost effectiveness
Type: Eposter Presentation
Background
In ASPIRE, KRd achieved superior progression free survival (PFS) (HR = 0.69; p = 0.0001) and improved quality of life (QoL) (p < 0.001) over Rd in patients (pts) with R/RMM.
Aims
We assessed the cost-effectiveness (CE) of KRd vs Rd from a US payer perspective with data from ASPIRE and long-term overall survival (OS) data from the Surveillance, Epidemiology, and End Results Program (SEER).
Methods
A partitioned-survival model with progression-free (PF), post-progression (PP) and death states was built with a 30 year horizon. Treatment (Tx) effect for PFS and OS was estimated with parametric regression models and applied over the time horizon. Since 60% of pre-specified OS events were observed, post-trial OS transition probabilities were estimated by matching SEER data to ASPIRE pts. Grade ≥ 3 adverse events (AEs) with > 2% incidence in any ASPIRE arm were included. Utilities were derived from literature and adjusted for the relative improvement in QoL increase observed when pts were PF in ASPIRE. Costs related to drug (WAC prices) as well as wastage (30% for carfilzomib), administration, monitoring, AE management, and subsequent Tx were considered. Tx duration was derived fitting ASPIRE data and carfilzomib was dosed up to 18 cycles. The base case assessed the CE of adding carfilzomib to Rd, and considered only additional costs of carfilzomib, i.e. neglecting Rd drug costs in both arms. A scenario including Rd costs in both arms was conducted. A 3% discount rate was applied to costs and outcomes.
Results
KRd was more effective compared to Rd, providing 1.134 PF life year, 1.927 life year, and 1.616 quality-adjusted life year (QALY) gains over the modelled horizon. KRd incurred $123,524 in total additional costs. Incremental CE ratio (ICER) was $76,416/QALY. With the inclusion of Rd costs, KRd incurred $179,863 additional costs with an ICER of $111,270/QALY.
Conclusion
The model predicts that KRd delivers nearly 2.86 additional undiscounted life year’s over the standard of care (Rd), and is cost-effective vs. Rd at a willingness-to-pay threshold of $120,000/QALY. Therefore, carfilzomib when added to Rd delivers considerable incremental value to patients and payers.
Session topic: E-poster
Keyword(s): Cost effectiveness
Abstract: E1273
Type: Eposter Presentation
Background
In ASPIRE, KRd achieved superior progression free survival (PFS) (HR = 0.69; p = 0.0001) and improved quality of life (QoL) (p < 0.001) over Rd in patients (pts) with R/RMM.
Aims
We assessed the cost-effectiveness (CE) of KRd vs Rd from a US payer perspective with data from ASPIRE and long-term overall survival (OS) data from the Surveillance, Epidemiology, and End Results Program (SEER).
Methods
A partitioned-survival model with progression-free (PF), post-progression (PP) and death states was built with a 30 year horizon. Treatment (Tx) effect for PFS and OS was estimated with parametric regression models and applied over the time horizon. Since 60% of pre-specified OS events were observed, post-trial OS transition probabilities were estimated by matching SEER data to ASPIRE pts. Grade ≥ 3 adverse events (AEs) with > 2% incidence in any ASPIRE arm were included. Utilities were derived from literature and adjusted for the relative improvement in QoL increase observed when pts were PF in ASPIRE. Costs related to drug (WAC prices) as well as wastage (30% for carfilzomib), administration, monitoring, AE management, and subsequent Tx were considered. Tx duration was derived fitting ASPIRE data and carfilzomib was dosed up to 18 cycles. The base case assessed the CE of adding carfilzomib to Rd, and considered only additional costs of carfilzomib, i.e. neglecting Rd drug costs in both arms. A scenario including Rd costs in both arms was conducted. A 3% discount rate was applied to costs and outcomes.
Results
KRd was more effective compared to Rd, providing 1.134 PF life year, 1.927 life year, and 1.616 quality-adjusted life year (QALY) gains over the modelled horizon. KRd incurred $123,524 in total additional costs. Incremental CE ratio (ICER) was $76,416/QALY. With the inclusion of Rd costs, KRd incurred $179,863 additional costs with an ICER of $111,270/QALY.
Conclusion
The model predicts that KRd delivers nearly 2.86 additional undiscounted life year’s over the standard of care (Rd), and is cost-effective vs. Rd at a willingness-to-pay threshold of $120,000/QALY. Therefore, carfilzomib when added to Rd delivers considerable incremental value to patients and payers.
Session topic: E-poster
Keyword(s): Cost effectiveness
Type: Eposter Presentation
Background
In ASPIRE, KRd achieved superior progression free survival (PFS) (HR = 0.69; p = 0.0001) and improved quality of life (QoL) (p < 0.001) over Rd in patients (pts) with R/RMM.
Aims
We assessed the cost-effectiveness (CE) of KRd vs Rd from a US payer perspective with data from ASPIRE and long-term overall survival (OS) data from the Surveillance, Epidemiology, and End Results Program (SEER).
Methods
A partitioned-survival model with progression-free (PF), post-progression (PP) and death states was built with a 30 year horizon. Treatment (Tx) effect for PFS and OS was estimated with parametric regression models and applied over the time horizon. Since 60% of pre-specified OS events were observed, post-trial OS transition probabilities were estimated by matching SEER data to ASPIRE pts. Grade ≥ 3 adverse events (AEs) with > 2% incidence in any ASPIRE arm were included. Utilities were derived from literature and adjusted for the relative improvement in QoL increase observed when pts were PF in ASPIRE. Costs related to drug (WAC prices) as well as wastage (30% for carfilzomib), administration, monitoring, AE management, and subsequent Tx were considered. Tx duration was derived fitting ASPIRE data and carfilzomib was dosed up to 18 cycles. The base case assessed the CE of adding carfilzomib to Rd, and considered only additional costs of carfilzomib, i.e. neglecting Rd drug costs in both arms. A scenario including Rd costs in both arms was conducted. A 3% discount rate was applied to costs and outcomes.
Results
KRd was more effective compared to Rd, providing 1.134 PF life year, 1.927 life year, and 1.616 quality-adjusted life year (QALY) gains over the modelled horizon. KRd incurred $123,524 in total additional costs. Incremental CE ratio (ICER) was $76,416/QALY. With the inclusion of Rd costs, KRd incurred $179,863 additional costs with an ICER of $111,270/QALY.
Conclusion
The model predicts that KRd delivers nearly 2.86 additional undiscounted life year’s over the standard of care (Rd), and is cost-effective vs. Rd at a willingness-to-pay threshold of $120,000/QALY. Therefore, carfilzomib when added to Rd delivers considerable incremental value to patients and payers.
Session topic: E-poster
Keyword(s): Cost effectiveness
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