Cost-Utility Analysis of adding daratumumab to bortezomib plus dexamethasone to treat Relapsed/Refractory Multiple Myeloma in Egypt

Menna M. ElSherbiny, Faculty of Pharmacy Cairo University, Cairo, 11562, Egypt
Ahmed M. Kamel, Clinical Pharmacy Department, Faculty of Pharmacy Cairo University, Cairo, 11562, EgyptFollow
Samar F. Farid, Clinical Pharmacy Department, Faculty of Pharmacy Cairo University, Cairo, 11562, Egypt

Subject Area

Pharmacology and Clinical Pharmacy

Abstract

Background: According to the CASTOR trial, DARA is shown to be effective as a second line for RRMM patients either as monotherapy or in combination with the gold standard regimen. The current study is the first to evaluate the cost-effectiveness of DARA based on the full results (~80-month follow-up) of the CASTOR trial. The study aimed to assess the cost-effectiveness of incorporating DARA, with bortezomib and dexamethasone, in treating patients from the perspective of a healthcare payer over a lifetime horizon.

Methods: A partition survival model (PSM) was adopted. The alternative arms chosen were daratumumab added to bortezomib plus dexamethasone (DaraVd) compared to bortezomib plus dexamethasone (Vd) alone. Only the total direct costs were included, and the study was conducted from the healthcare payer perspective. The utility values for the progression-free survival (PFS) and overall survival (OS) were obtained from the literature. Sensitivity analysis was performed deterministically and probabilistically using 1000 Monte Carlo simulations.

Results: The incremental cost-effectiveness ratios (ICER) obtained using deterministic and PSA were $3,833/QALY and $6,944/QALY, respectively. Using a willingness to pay threshold (WTP) of $13,755, the DaraVd dominated the Vd regimen. The results supported using a daratumumab-based regimen for treating relapsed/ refractory multiple myeloma patients (RRMM).

Conclusion: The daratumumab-based regimen was cost-effective. These results support adding DARA to bortezomib and dexamethasone rather than using bortezomib and dexamethasone alone to treat transplant-ineligible relapsed/ refractory multiple myeloma patients (RRMM).

Recommended Citation

ElSherbiny, Menna M.; Kamel, Ahmed M.; and Farid, Samar F. (2023) "Cost-Utility Analysis of adding daratumumab to bortezomib plus dexamethasone to treat Relapsed/Refractory Multiple Myeloma in Egypt," Bulletin of Faculty of Pharmacy Cairo University: Vol. 61 : Iss. 2 , Article 9.
Available at: https://doi.org/10.54634/2090-9101.1059