Muhammad Bilal Abid: Balancing Accessibility and Cost-Efficiency in Multiple Myeloma Treatment
M. Bilal Abid/LinkedIn

Muhammad Bilal Abid: Balancing Accessibility and Cost-Efficiency in Multiple Myeloma Treatment

Muhammad Bilal Abid, Medical Director, Blood and Marrow Transplantation and Cellular Therapy Program at Texas Tech University Health Sciences Center, shared a post on LinkedIn about a recent article he and his colleagues co-authored, adding:

“Hot off the press

‘Cost-effective analysis of teclistamab and daratumumab versus ciltacabtagene autoleucel in relapsed multiple myeloma’

The MajesTEC-3 and MajesTEC-9 (presented at recent American Society of Clinical Oncology (ASCO) trials evaluated bispecific antibody (BsAb) therapies for multiple myeloma (Tec-Dara and Teclistamab). These regimens yield survival and response rates rivaling CAR T-cell therapy, but offer off-the-shelf availability without the need for complex, weeks-long cell manufacturing.

Given the potential cost differences between a one-time CAR-T infusion, which carries unique access and logistical barriers, and continuous BsAb therapy, we conducted a cost-effectiveness analysis of tec/dara versus cilta-cel from a US payers’ perspective.

We applied several models to ensure robustness and found that in the base-case analysis over a 10-year horizon, the MajesTEC-3 tec/dara regimen incurred a total cost of $1,122,707 and generated 5.219 QALYs. In comparison, cilta-cel was associated with a total cost of $557,021 and yielded 3.125 QALYs.

Consequently, tec/dara was associated with an additional cost of $565,685.53 and a corresponding gain of 2.094 QALYs. At a WTP threshold of $150,000 per QALY, tec/dara was not cost-effective relative to cilta-cel. Further exploration via deterministic one-way sensitivity analysis demonstrated that teclistamab treatment duration cap is the most influential driver of ICER.

Our findings call for response-adapted treatment discontinuation for balancing the regimen’s cost with its survival benefits. As the myeloma treatment landscape evolves, balancing the superior accessibility of bispecific antibodies against the cost-efficiency of one-time cellular therapies will be paramount for sustainable and equitable healthcare delivery.

This was a labor of love from a team of mentees, led by a budding oncologist, an incoming IM resident, Sohaib Irfan, and a stellar medical student, Muhammad Abdullah Jamil

Open access link is given below. Looking forward to input from myeloma and modeling experts!”

Title: Cost-effective analysis of teclistamab and daratumumab versus ciltacabtagene autoleucel in relapsed multiple myeloma

Authors: Sohaib Irfan, M. Abdullah Jamil, Muhammad Bilal Abid

Read the Full Article on British Journal of Haematology

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