Contributions
Abstract: PB1951
Type: Publication Only
Background
Proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs) and treatments involving both a PI and an IMiD (PI+IMiD) are the principal therapies for treating relapsed/refractory multiple myeloma (RRMM). The widespread adoption of these treatments may come with high healthcare resource utilization (HCRU), of which key drivers are reported in past research. It is important to further understand HCRU by different treatment modalities in real-world practice settings.
Aims
To evaluate HCRU in patients receiving different treatment modalities for RRMM.
Methods
US patients with RRMM, aged ≥18 y, with at least one prior therapy who initiated treatment with a PI, IMiD or IMiD+PI within 90 d before or 30 d after study enrollment (index therapy), were identified from PREAMBLE, an ongoing, prospective, multinational, non-interventional observational study. Patient data collected at each healthcare provider (HCP) visit, over a 3-y period or until the end of patient follow-up, included clinic/physician office visits; home healthcare, hospital outpatient and emergency room visits; and hospitalizations. Demographics and baseline characteristics were summarized using descriptive statistics. HCRU and its associated costs were analyzed using a standard per-1000 patients-per-month metric.
Results
287 patients (median age 66 y; 56% male) were enrolled in the US. At the time of data cut-off (Sep 2016), 136 (47%) were still in the study and 151 (53%) had withdrawn; 92 (61%) of those withdrawn had died. Median (range) follow-up was 12.7 (0.5–41.0) mo. At study entry, patients were divided into three cohorts based on index therapy: PI (n=162, 56%; carfilzomib n=82/162; bortezomib n=80/162), IMiD (n=74, 26%; pomalidomide n=32/74; lenalidomide/thalidomide n=42/74), and PI+IMiD (n=51, 18%; carfilzomib and/or pomalidomide n=17/51; other n=34/51). The three groups were similar with regard to sex, race, disease status, ISS stage, comorbidities and number of prior therapies (Table). The median duration of treatment (mDoT) was longer for patients on IMiD (6.4 mo), but shorter for those on PI (4.2 mo) or PI+IMiD (4.4 mo). In the PI cohort, carfilzomib had a shorter mDoT than bortezomib (3.5 vs 4.7 mo). Of 3220 total HCP visits, the most common type was clinic/physician office (2732, 85%), followed by hospitalization (210, 7%) and hospital outpatient (54, 5%). Mean per-1000 patients-per-month total visits were higher for PI+IMiD (876) than for PI (750) and IMiD (494). This remained true for clinic/physician office, hospital outpatient and home healthcare/other. Patients on PI had more visits for management of MM treatment-related events (16%) than those on PI+IMiD (10%) or IMiD (7%) (Table). Notably, among patients on PI, those on carfilzomib had high mean per-1000 patients-per-month total visits (827), with per-1000 patients-per-month emergency room visits (18) and hospitalizations (78) higher than any other treatment; 19% (175) of visits were made for management of treatment-related events.
Conclusion
Routine management of MM and treatment-related events drive HCRU, which may differ by treatment. Hospitalizations and hospital outpatient visits remain key drivers of HCRU in MM, which highlights an unmet medical need for effective therapy with better safety profiles.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Health care, Cost analysis, Treatment, Multiple Myeloma
Abstract: PB1951
Type: Publication Only
Background
Proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs) and treatments involving both a PI and an IMiD (PI+IMiD) are the principal therapies for treating relapsed/refractory multiple myeloma (RRMM). The widespread adoption of these treatments may come with high healthcare resource utilization (HCRU), of which key drivers are reported in past research. It is important to further understand HCRU by different treatment modalities in real-world practice settings.
Aims
To evaluate HCRU in patients receiving different treatment modalities for RRMM.
Methods
US patients with RRMM, aged ≥18 y, with at least one prior therapy who initiated treatment with a PI, IMiD or IMiD+PI within 90 d before or 30 d after study enrollment (index therapy), were identified from PREAMBLE, an ongoing, prospective, multinational, non-interventional observational study. Patient data collected at each healthcare provider (HCP) visit, over a 3-y period or until the end of patient follow-up, included clinic/physician office visits; home healthcare, hospital outpatient and emergency room visits; and hospitalizations. Demographics and baseline characteristics were summarized using descriptive statistics. HCRU and its associated costs were analyzed using a standard per-1000 patients-per-month metric.
Results
287 patients (median age 66 y; 56% male) were enrolled in the US. At the time of data cut-off (Sep 2016), 136 (47%) were still in the study and 151 (53%) had withdrawn; 92 (61%) of those withdrawn had died. Median (range) follow-up was 12.7 (0.5–41.0) mo. At study entry, patients were divided into three cohorts based on index therapy: PI (n=162, 56%; carfilzomib n=82/162; bortezomib n=80/162), IMiD (n=74, 26%; pomalidomide n=32/74; lenalidomide/thalidomide n=42/74), and PI+IMiD (n=51, 18%; carfilzomib and/or pomalidomide n=17/51; other n=34/51). The three groups were similar with regard to sex, race, disease status, ISS stage, comorbidities and number of prior therapies (Table). The median duration of treatment (mDoT) was longer for patients on IMiD (6.4 mo), but shorter for those on PI (4.2 mo) or PI+IMiD (4.4 mo). In the PI cohort, carfilzomib had a shorter mDoT than bortezomib (3.5 vs 4.7 mo). Of 3220 total HCP visits, the most common type was clinic/physician office (2732, 85%), followed by hospitalization (210, 7%) and hospital outpatient (54, 5%). Mean per-1000 patients-per-month total visits were higher for PI+IMiD (876) than for PI (750) and IMiD (494). This remained true for clinic/physician office, hospital outpatient and home healthcare/other. Patients on PI had more visits for management of MM treatment-related events (16%) than those on PI+IMiD (10%) or IMiD (7%) (Table). Notably, among patients on PI, those on carfilzomib had high mean per-1000 patients-per-month total visits (827), with per-1000 patients-per-month emergency room visits (18) and hospitalizations (78) higher than any other treatment; 19% (175) of visits were made for management of treatment-related events.
Conclusion
Routine management of MM and treatment-related events drive HCRU, which may differ by treatment. Hospitalizations and hospital outpatient visits remain key drivers of HCRU in MM, which highlights an unmet medical need for effective therapy with better safety profiles.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Health care, Cost analysis, Treatment, Multiple Myeloma