Cost-effectiveness of Pomalidomide, Carfilzomib, and Daratumumab for the Treatment of Patients with Heavily Pretreated Relapsed–refractory Multiple Myeloma.

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Cost-effectiveness of Pomalidomide, Carfilzomib, and Daratumumab for the Treatment of Patients with Heavily Pretreated Relapsed–refractory Multiple Myeloma in the United States Christopher G. Pelligra, Kejal Parikh, MS, Shien Guo, PhD, Conor Chandler, Jorge Mouro, MS, Safiya Abouzaid, MPH, PharmD, Sikander Ailawadhi, MD Clinical Therapeutics Volume 39, Issue 10, Pages 1986-2005.e5 (October 2017) DOI: 10.1016/j.clinthera.2017.08.010 Copyright © 2017 The Authors Terms and Conditions

Figure 1 Diagram of health economic model illustrating health states and possible transitions. Clinical Therapeutics 2017 39, 1986-2005.e5DOI: (10.1016/j.clinthera.2017.08.010) Copyright © 2017 The Authors Terms and Conditions

Figure 2 Plot of progression-free survival parametric distributions for pomalidomide plus low-dose dexamethasone (POM-d), daratumumab monotherapy (DARA), and carfilzomib (CAR) used in the economic model. Clinical Therapeutics 2017 39, 1986-2005.e5DOI: (10.1016/j.clinthera.2017.08.010) Copyright © 2017 The Authors Terms and Conditions

Figure 3 Deterministic sensitivity analysis tornado diagrams illustrating the one-way impact of varying key parameters on pomalidomide plus low-dose dexamethasone (POM-d) versus daratumumab monotherapy (DARA) and POM-d versus carfilzomib monotherapy (CAR).AE = adverse event; BSA = body surface area; HR = hazard ratio; PF = progression-free; PFS = progression-free survival; RDI = relative dose intensity; TTF = time to treatment failure. Clinical Therapeutics 2017 39, 1986-2005.e5DOI: (10.1016/j.clinthera.2017.08.010) Copyright © 2017 The Authors Terms and Conditions

Figure 4 Incremental cost-effectiveness plane illustrating results of probabilistic sensitivity analyses, with effectiveness measured in incremental quality-adjusted life-years (QALYs).CAR = carfilzomib monotherapy; DARA = daratumumab monotherapy; ICER = incremental cost-effectiveness ratio. Clinical Therapeutics 2017 39, 1986-2005.e5DOI: (10.1016/j.clinthera.2017.08.010) Copyright © 2017 The Authors Terms and Conditions

Figure 5 Cost-effectiveness acceptability curves illustrating results of probabilistic sensitivity analyses, with effectiveness measured in quality-adjusted life-years (QALYs).CAR = carfilzomib monotherapy; DARA = daratumumab monotherapy; POM-d = pomalidomide plus low-dose dexamethasone. Clinical Therapeutics 2017 39, 1986-2005.e5DOI: (10.1016/j.clinthera.2017.08.010) Copyright © 2017 The Authors Terms and Conditions

Figure 6 Incremental cost-effectiveness plane illustrating results of scenario analyses, with effectiveness measured in quality-adjusted life-years (QALYs) (each point represents the results of one scenario). CAR = carfilzomib monotherapy; DARA = daratumumab monotherapy; ICER = incremental cost-effectiveness ratio. Clinical Therapeutics 2017 39, 1986-2005.e5DOI: (10.1016/j.clinthera.2017.08.010) Copyright © 2017 The Authors Terms and Conditions

Figure S1 Plot of observed progression-free survival data for POM-d arm of the MM-002 study and fitted parametric distributions. Clinical Therapeutics 2017 39, 1986-2005.e5DOI: (10.1016/j.clinthera.2017.08.010) Copyright © 2017 The Authors Terms and Conditions

Figure S2 Plot of observed post-progression survival data for POM-d arm of the MM-002 study and fitted parametric distributions. Clinical Therapeutics 2017 39, 1986-2005.e5DOI: (10.1016/j.clinthera.2017.08.010) Copyright © 2017 The Authors Terms and Conditions

Figure S3 Incremental cost-effectiveness plane illustrating results of probabilistic sensitivity analyses, with effectiveness measured in incremental life years.CAR=carfilzomib monotherapy; DARA=daratumumab monotherapy; ICER=incremental cost-effectiveness ratio; LY=life year. Clinical Therapeutics 2017 39, 1986-2005.e5DOI: (10.1016/j.clinthera.2017.08.010) Copyright © 2017 The Authors Terms and Conditions

Figure S4 Cost-effectiveness acceptability curves illustrating results of probabilistic sensitivity analyses, with effectiveness measured in life years.CAR=carfilzomib monotherapy; DARA=daratumumab monotherapy; LY=life year; POM-d=pomalidomide plus low-dose dexamethasone. Clinical Therapeutics 2017 39, 1986-2005.e5DOI: (10.1016/j.clinthera.2017.08.010) Copyright © 2017 The Authors Terms and Conditions

Figure S5 Incremental cost-effectiveness plane illustrating results of scenario analyses, with effectiveness measured in life years (each point represents the results of one scenario).CAR=carfilzomib monotherapy; DARA=daratumumab monotherapy; ICER=incremental cost-effectiveness ratio; LY=life year. Clinical Therapeutics 2017 39, 1986-2005.e5DOI: (10.1016/j.clinthera.2017.08.010) Copyright © 2017 The Authors Terms and Conditions