肿瘤细胞治疗研究
英文原题：Economic Impact of Elranatamab for Treatment of Patients with Relapsed or Refractory Multiple Myeloma.
Economic Impact of Elranatamab for Treatment of Patients with Relapsed or Refractory Multiple Myeloma.
Elranatamab用于RRMM预计在3年内产生极小至小的预算影响，并具有良好的经济价值，与除ciltacabtagene autoleucel外的其他可用RRMM治疗相比，每PFS月的护理成本更低。
估计将 elranatamab 纳入美国处方集用于治疗已接受过≥4线既往治疗（包括蛋白酶体抑制剂、免疫调节药物和抗CD38单克隆抗体）的RRMM成人患者的预算影响，并评估 elranatamab 与现有治疗之间的总护理成本及每无进展生存期（PFS）月成本。
开发了一个经济模型，用于评估 elranatamab 在一个拥有百万成员的美国商业和 Medicare 健康计划中的预算影响。流行病学数据来自 SEER 数据库和一项大型美国真实世界研究。关键临床输入包括治疗持续时间、PFS、总生存期和不良事件（AE）。纳入了与药物获取监测、医疗资源使用（具体为住院和医生就诊）以及 AE 相关的成本。模型输入来源于临床试验数据、美国政府数据库和已发表文献。评估了总预算影响和每成员每月（PMPM）。进行了单因素敏感性分析（OWSA）以评估模型输入的不确定性。还评估了总护理成本和每 PFS 月成本。
估计每年有14例（商业保险）和60例（Medicare）RRMM患者符合治疗条件。加入elranatamab后，三年内商业保险的总预算影响为$553,607（$0.05 PMPM），Medicare为$2,351,515（$0.20 PMPM）。OWSA表明，结果对elranatamab药物成本和相对剂量强度最为敏感。一年内中位PFS的每月总护理成本，elranatamab为$19,642，talquetamab（$33,391），teclistamab（$37,791），selinexor加dexamethasone（$48,784），医生选择治疗（$65,886），idecabtagene vicleucel（$78,361），以及ciltacabtagene autoleucel（$17,640）。
PURPOSE: To estimate the budget impact of adding elranatamab to the US formulary to treat adults with RRMM who have received ≥4 prior lines of therapy including a proteasome inhibitor, an immunomodulatory drug, and an anti-CD38 monoclonal antibody, and to assess the total cost of care and cost per month of progression-free survival (PFS) between elranatamab and available treatments. METHODS: An economic model was developed to assess the budget impact of elranatamab in a one-million-member US commercial and Medicare health plan. Epidemiology data was obtained from the SEER database and a large US real-world study. Key clinical inputs included treatment duration, PFS, overall survival, and adverse events (AEs). Costs associated with drug acquisition monitoring, medical resource use (specifically hospitalization and physician visits), and AEs were incorporated. Model inputs were sourced from clinical trial data, US government databases, and published literature. Total budget impact and per member per month (PMPM) were assessed. One-way sensitivity analyses (OWSA) were conducted to assess model input uncertainty. Total cost of care and cost per month of PFS were also assessed. RESULTS: An estimated 14 (commercial) and 60 (Medicare) RRMM patients per year would be eligible for treatment. Adding elranatamab resulted in a total budget impact of $553,607 ($0.05 PMPM) in commercial and $2,351,515 ($0.20 PMPM) in Medicare over three years. OWSA indicated results were most sensitive for elranatamab drug costs and relative dose intensity. Total cost of care per month of median PFS over one year was $19,642 with elranatamab, talquetamab ($33,391), teclistamab ($37,791), selinexor plus dexamethasone ($48,784), physician's choice of treatment ($65,886), idecabtagene vicleucel ($78,361), and ciltacabtagene autoleucel ($17,640). CONCLUSION: Elranatamab for RRMM is projected to result in a minimal to small budget impact over 3 years and good economic value with lower cost of care per month of PFS compared with other available RRMM treatments except for ciltacabtagene autoleucel.
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