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• W4244544907 abstract "6548 Background: Pegylated liposomal doxorubicin (Doxil/Caelyx) was used in place of doxorubicin in a regimen to treat multiple myeloma. This study evaluates the cost effectiveness (CE) of the regimen. Methods: This economic model evaluates the expected treatment cost and CE of DVd (pegylated liposomal doxorubicin 40 mg/m2 IV Day 1, vincristine 1.4 mg/m2 [max 2.0 mg/m2] IV Day 1, and reduced-dose dexamethasone 40 mg PO Days 1–4) vs VAd (vincristine 0.4 mg/day and conventional doxorubicin 9 mg/m2/day by continuous IV infusion Days 1–4 and reduced-dose dexamethasone 40 mg PO Days 1–4) in patients with newly diagnosed multiple myeloma. A payer's perspective is adopted. Clinical results and resource use are drawn from a randomized, multicenter comparative trial. Resources are valued via the following: 2003 Drug Topics Red Book (drug acquisition); 2001 HCUPnet (inpatient administration fees); and 2003 National Medicare Fee Schedule (outpatient administration fees). CE is calculated as expected cost per objective response (CR/R/PR, SWOG). Results: Data on 175/198 patients (87 DVd; VAd 88) are included. Baseline characteristics are balanced across groups. The percent of patients reporting adverse events is similar, although frequency of grade 3/4 neutropenia is significantly lower for DVd vs VAd (8.0% [95%CI 2.3–13.8] vs 22.7% [14.0–31.5]). Patients in each group received similar number of chemotherapy cycles (DVd 3.4 vs VAd 3.2, P=.53), however, patients receiving DVd required significantly fewer cumulative days in the hospital or outpatient setting for drug administration (4.8 vs 21.6 days, respectively; P<.0001). 4% of the DVd cycles vs 35% of VAd cycles were administered in the hospital (P<.0001). Expected drug costs per cycle are higher for DVd compared to VAd ($3,307.80 vs $155.49), but, total expected costs per patient are lower after accounting for inpatient and outpatient administration fees ($13,972.21 vs $23,507.16). 44% of DVd compared to 39% of VAd patients had an objective response. The CE ratio for DVd is superior to VAd ($31,755.02 vs $60,274.78) due to the lower expected treatment cost. Conclusions: In this model, DVd is equally effective and less costly (dominates) than VAd. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Ortho Biotech Products, L.P. Ortho Biotech Products, L.P. Ortho Biotech Products, L.P. Alza; Ortho Biotech Products, LP" @default.
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• W4244544907 date "2004-07-15" @default.
• W4244544907 modified "2023-09-27" @default.
• W4244544907 title "Cost effectiveness of DVd vs VAd in newly diagnosed multiple myeloma" @default.
• W4244544907 doi "https://doi.org/10.1200/jco.2004.22.90140.6548" @default.
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