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• W4387373822 abstract "Despite its promising outcome, anti-BCMA CAR-T is the most expensive myeloma treatment that has ever been developed, and its cost-effectiveness is an important issue. This study aimed to assess the cost-effectiveness of anti-BCMA CAR-T in comparison with standard anti-myeloma therapy in RRMM patients. The model assumed myeloma patients in Japan and the US who have received ≥3 prior lines of anti-myeloma therapies including PIs, IMiDs, and anti-CD38 mAbs. A Markov model was constructed to compare the ‘CAR-T’ strategy, in which patients receive either idecabtagene vicleucel (ide-cel) or ciltacabtagene autoleucel (cilta-cel) followed by three lines of multiagent chemotherapy after relapse, to the ‘no CAR-T’ strategy, in which patients only receive chemotherapies. The data from the LocoMMotion, KarMMa, and CARTITUDE-1 trials were extracted. Several assumptions were made regarding long-term progression-free survival (PFS) with CAR-Ts. Extensive scenario analyses were made regarding regimens for ‘no CAR-T’ strategies. The outcome was an incremental cost-effectiveness ratio (ICER) with willingness-to-pay thresholds of 7,500,000 in Japan and $150,000 in the US. When a 5-year PFS of 40% with cilta-cel was assumed, the ICER of the ‘CAR-T’ versus ‘no CAR-T’ strategies was 7,603,823 in Japan and $112,191 in the US per QALY over a 10-year time horizon. When a 5-year PFS of 15% with ide-cel was assumed, the ICER was 20,388,711 in Japan and $261,678 in the US per QALY over a 10-year time horizon. The results were highly dependent on the PFS assumption with CAR-T and were robust to changes in most other parameters and scenarios. Although anti-BCMA CAR-T can be cost-effective even under current pricing, a high long-term PFS is necessary." @default.
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• W4387373822 date "2023-10-01" @default.
• W4387373822 modified "2023-10-08" @default.
• W4387373822 title "Cost-effectiveness of anti-BCMA chimeric antigen receptor T cell therapy in relapsed/ refractory multiple myeloma" @default.
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• W4387373822 doi "https://doi.org/10.1016/j.jtct.2023.10.001" @default.
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