Patient-Reported Quality of Life Outcomes in Multiple Myeloma Favor Cilta-Cel

In patients with relapsed or refractory multiple myeloma (MM), treatment with ciltacabtagene autoleucel (cilta-cel) was significantly more cost-effective compared with physician’s choice of daratumumab, pomalidomide, and dexamethasone (DPd) or pomalidomide plus bortezomib and dexamethasone (PVd), according to a cost-per-responder analysis of the CARTITUDE-4 trial.

The findings were presented by Doris Hansen, MD, of the Moffitt Cancer Center in Tampa, Florida, at the 65th American Society of Hematology Annual Meeting & Exposition in San Diego, California. Dr. Hansen stated that the cost per responder and cost per month in progression-free survival (PFS) were “remarkably lower” for cilta-cel compared with DPd or PVd.

The cohort was analyzed from a mixed-payer perspective, with 67.7% commercially insured and 23.3% insured by Medicare. In the physician’s choice group, 87% of patients received DPd and 13% received PVd.

The total cost, defined as combined PFS and post-progression survival (PPS), was estimated at $693,009 per patient treated with cilta-cel compared with $1,028,444 per patient treated with physician’s choice over 25.4 months of follow-up. Additionally, total estimated costs during separate PFS and PPS were lower for cilta-cel at $581,108 and $111,901, respectively, versus physician’s choice at $765,169 and $263,275, respectively. Total cost per complete response was estimated at $948,029 with cilta-cel versus $4,717,634 with DPd or PVd.

According to the authors, the primary driver of cost during PFS was treatment acquisition. It was cost of subsequent treatments during PPS.

“Overall, cilta-cel offers substantial clinical and economic benefit” compared with physician’s choice of DPd or PVd in patients with relapsed or refractory MM, Dr. Hansen and colleagues concluded.

Reference

Hansen DK, Lu X, Castaneda O, et al. Cost per responder analysis of patients with lenalidomide-refractory multiple myeloma who received cilta-cel from the Cartitude-4 trial. Abstract #5083. Presented at the 65th ASH Annual Meeting & Exposition; December 9-12, 2023; San Diego, California.