Survival, health care resource utilization and expenditures of first-line treatments for multiple myeloma patients ineligible for transplant in Taiwan

• Published in: PloS one Vol. 16; no. 5; p. e0252124
• Main Authors: Cheng, Chih-Ning, Huang, Shang-Yi, Lien, Pei-Wen, Huang, Shih-Ting, Lin, Fang-Ju
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 26.05.2021; Public Library of Science (PLoS)
• Subjects: Anemia; Biomedical materials; Bone lesions; Cancer; Care and treatment; Catastrophic failure analysis; Cell proliferation; Codes; Diagnosis; Editing; Emergency medical care; Evaluation; Expenditures; Health care expenditures; Health insurance; Hospitals; Illnesses; Medical care; Medical care, Cost of; Medicine; Medicine and Health Sciences; Methodology; Mortality; Multiple myeloma; Osteolysis; Patient admissions; Patients; People and Places; Pharmaceuticals; Pharmacy; Plasma cells; Population; Renal failure; Resource utilization; Social Sciences; Stem cell transplantation; Stem cells; Survival; Transplants & implants; Utilization; Taiwan; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0252124

We aimed to provide real-world information on survival, health care resource utilization (HCRU), and expenditures related to various first lines of therapy (1LOTs) in newly diagnosed multiple myeloma (NDMM) patients who were transplant ineligible (TI). From the Taiwan National Health Insurance Database (2008-2016), we identified 1,511 NDMM-TI patients who had received 1LOT since June 2012. We categorized 1LOT regimens into four groups: bortezomib (V)+thalidomide (T), V, T, and non-V/T. Patients' characteristics were collected. The overall survival (OS), event-free survival (EFS), frequencies of HCRU (hospitalization, visiting outpatient and emergency departments), and related expenditures within one year after commencement of the 1LOT were evaluated and compared. The mean age of the included patients was 71.3 (SD 10.7) years, and 40.4% of patients had a CCI score [greater than or equal to]3. Most patients (747; 49.4%) were in the V+T group and, after adjusting for covariates, had a significantly longer OS (median, 22.2 months) and EFS (9.1 months) than those in the T group (12.6 and 4.5 months, respectively) and the non-V/T group (12.2 and 3.2 months, respectively), but they were mostly comparable with patients in the V group (23.8 and 6.6 months, respectively). Compared to those in the V+T group, patients in the T and non-V/T groups had 29% and 39% fewer outpatient visits and 15% and 24% lower total expenditure, respectively. Our real-world data consolidate evidence for the effectiveness of bortezomib-containing regimens as the 1LOT in NDMM-TI patients at the expense of more outpatient visits and higher total costs.