PSY7 Budget Impact Analysis of Bendamustine in the Treatment of Multiple Myeloma in Spain

Abstract

OBJECTIVES: To estimate the Budget Impact of Bendamustine introduction as a treatment option for Multiple Myeloma (MM) patients, non-candidates for transplantation, who are likely to be treated with high priced citostatic combinations. METHODS: A Budget Impact model assuming a prevalent treatable population of 4826 patients with MM, with an incremental rate of 3% per year. The time horizon considered was three years and the analysis was made from the perspective of the Spanish Health System. Nine treatment cycles were considered for all the drug regimens and for the treatment lines included (3 or more). Pharmaceutical expenditure on citostatic agents was analyzed, excluding other medical costs. The drug costs were based on the official ex-factory prices (EFP), discounting the price reduction recently established by the Spanish Government. The base case scenario was based on prevalent epidemiological, market research data available and experts opinion input. The bendamustine scenario considered different drug combinations and different dosages (90-120mg/m2), depending on the treatment line to analyze. RESULTS: The drug expenditure for MM treatment is slightly under €120 Mio/year in Spain. The single cycle costs range from €3 (Melphalan+Prednisone) to €5969 (Lenalidomide-Dexamethasone). Bendamustine based treatments would reach 7% to 21% of the treated patients from the first to the last year analyzed. Fifty-four percent of the Bendamustine treatments considered were combinations with other expensive drugs (Bortezomib or Thalidomide), where the Bendamustine cost was only 17% or 21% respectively of the whole treatment regimen. The introduction of Bendamustine would reduce drug expenditure in €6.6 Mio during the 3 years considered, expressed in €2011. CONCLUSIONS: The introduction of Bendamustine would produce drug cost savings in the MM patients, mainly from the 2nd treatment lines onwards. The savings observed in the model were mainly due to the substitution of high cost combinations like those based on Bortezomib, Thalidomide or Lenalidomide therapies.