Modeling First-Line Daratumumab Use for Newly Diagnosed, Transplant-Ineligible, Multiple Myeloma: A Cost-Effectiveness and Risk Analysis for Healthcare Payers

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Disease Area (Primary)

Multiple Myeloma

Disease Area (Secondary)

First Developed

04/21/2024

Last Developed

Software Used

R (e.g., heemod, BCEA, dampack, hesim)

Model Sponsor

Academic institution

Intervention

daratumumab_lenalidomide_and_dexamethasone

Model Validation Score

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Results

The incremental cost-effectiveness ratio (ICER) for daratumumab, lenalidomide, and dexamethasone (DRd) compared with bortezomib, lenalidomide, and dexamethasone (VRd) was US $90,364 per QALY gained. The results were sensitive to variations in survival for DRd, postprogression treatment costs, cost of hospice care, and hazard ratio for progression-free survival. The scenarios explored indicated that structural assumptions, such as the time horizon of the analysis, significantly influenced the results due to uncertainties arising from immature trial data and treatment efficacy over time. Among the various payer strategies compared, an upfront price discount for daratumumab emerged as the best approach with the lowest P-SUB at US $14,708.

Conclusion

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Model Review

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Summary
Validation Score

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