Cost-effectiveness of Daratumumab (Darzalex) for Adult Patients with RRMM

According to research published in Frontiers in Pharmacology, Addition of daratumumab (darzalex) to the standard care may help in order to improve the outcomes, but it is not cost-effective for untreated multiple myeloma patients. 

Multiple Myeloma basically is the second most common hematologic malignancy across the globe, and despite advancement in treatment, this disease remains incurable. Triplet therapy comprising bortezomib, melphalan, and prednisone (VMP) is a standard treatment for newly diagnosed, transplant ineligible multiple myeloma patients.

Addition of daratumumab to triplet therapy comprising bortezomib, melphalan, and prednisone (VMP) has reduced the risk of disease progression or death; however, it costs significantly more than the bortezomib, melphalan, and prednisone (VMP). 

The carried out study assessed the cost effectiveness of daratumumab plus bortezomib, melphalan, and prednisone vs bortezomib, melphalan, and prednisone for this patient group.

On behalf of the decision-analytic Markov model in order to simulate patients from the state of progression-free survival (PFS). Their model included a total of 350 patients in the daratumumab plus bortezomib, melphalan, and prednisone population and 356 in the bortezomib, melphalan, and prednisone population.

The $150,000 was the determined threshold of the willingness to pay per quality-adjusted life-years (QALYs). The analysis observed only direct medical care costs and was conducted through the perspective of U.S. payers.

Investigators used findings from the carried out trial named ALCYONE in order to simulate the progression free survival as well as overall survival findings for each treatment regimen.

Patients with daratumumab plus bortezomib, melphalan, and prednisone gained 6.40 quality adjusted life-years, which is 2.03 quality adjusted life-years more than the patients with bortezomib, melphalan, and prednisone, but at an incremental cost of $388,364 per quality adjusted life-year. The mean incremental costs of daratumumab plus bortezomib, melphalan, and prednisone were $788,541.

This was declared the first cost-effectiveness analysis of daratumumab for newly diagnosed, transplant ineligible multiple myeloma patients. Although other studies of RRMM patients often noted that the high cost of the daratumumab was basically not cost-effective during the comparison with clinical benefit.

In this carried out study, a sensitivity analysis noted that, even when adjusting for multiple parameters, the incremental cost-effectiveness ratio remained over $150,000. Along with that threshold, the addition of the daratumumab to the bortezomib, melphalan, and prednisone is not cost-effective.

Reference link:-

https://www.frontiersin.org/articles/10.3389/fphar.2021.608685/full

https://www.hematologyadvisor.com/home/topics/myeloma/multiple-myeloma-daratumumab-cost-effective-treatment/

Related:-

About Daratumumab:

Daratumumab, also named Darzalex, specifically is an anti-cancer drug, believed to bind to the CD38, which is primarily overexpressed in the cells of multiple myeloma. This anti-cancer medication was originally originated by Genmab, but it is currently being jointly developed by Genmab together with the Johnson & Johnson subsidiary named Janssen Biotech, which acquired worldwide commercialization rights to the medication from Genmab.

In November 2015, daratumumab got approval by the US Food and Drug Administration in order to treat MM (multiple myeloma) in individuals who had received at least 3-prior therapies.

In order to treat multiple myeloma through daratumumab (darzalex) potentially enhances the susceptibility of patient’s to bacterial as well as viral infections, due to destroying the natural killer cells. Daratumumab may be frequently responsible for causing human cytomegalovirus (CMV) reactivation. Injection associated reactions (inflammation-like) are also common.