Pharmacoeconomic Evaluation Of Carfilzomib In The Treatment Of Newly Diagnosed Multiple Myeloma

Background:Multiple myeloma(MM)is a plasma cell malignant proliferative disease and is the second most common hematological malignancy after lymphoma in many countries,accounting for 12%of hematological tumors.As a second-generation proteasome inhibitor,carfilzomib was approved by National Medical Products Administration(NMPA)in Combination with dexamethasone for patients with relapsed or refractory multiple myeloma(RRMM)on July 9,2021.Although it is still unable to cure Multiple myeloma completely,it also gives hope to multiple myeloma patients in China,and there is no research on long-term drug economy from the Perspective of China.In this study,we summarized the characteristics of existing pharmacoeconomic evaluations of multiple myeloma from a Chinese population perspective,analyzed by the CHEERS 2022 scale,and conducted a cost-effectiveness analysis from a Chinese healthcare payer perspective based on survival data from the ENDURANCE RCT trial.Methods:(1)EXCEL was used to summarize and analyze pharmacoeconomic evaluations of multiple myeloma(MM)from a Chinese population perspective,and CHEERS 2022 was used to evaluate the study quality.(2)Based on the(ENDURANCE)RCT,Individual patient data(IPD)required by subsequent economic models is fitted with R language.Data in Kaplan-Meier curves are extracted by Get Data Graph Digitizer.After cleaning,IPD prediction data in the trial were finally obtained,and the survival curve fitting was carried out by R language(surv HE),and the appropriate probability distribution function was selected.Tree Age Pro Health 2021 was used to establish a three-state Markov model to evaluate the cost-utility analysis between KRd(carfilzomib + lenalidomide + dexamethasone)and VRd(bortezomib + lenalidomide +dexamethasone)in the treatment of newly diagnosed multiple myeloma(MM).Result:The research results mainly include two aspects: quality of economic research and economy(cost-utility):1.Quality of pharmacoeconomic research:(1)A total of 13 studies were included in this study,of which 7 were collected from the researchers’ hospitals,4 from RCT trials,and 2 from meta-analysis.(2)The 13 studies to be included were quality-evaluated by CHEERS 2022.2.Economy(cost-utility):From the perspective of health payers in China,the 10-year survival status of newly diagnosed multiple myeloma(MM)patients was simulated by Markov model.The results showed that the quality-adjusted life year(QALY)of VRd group was longer than that of KRd group,and the cost is lower.The results show that VRd scheme is more economical than KRd scheme.Conclusion:From the perspective of Health payers in China,the treatment plan of VRd group is more economical.It is suggested to bring the price of carfezomib into medical insurance through negotiation and other means,so as to benefit more patients.