Healthcare resource utilization and costs in patients with multiple myeloma who received 1 to 3 prior lines of therapy, including a proteasome inhibitor and an immunomodulatory drug, and were exposed to and discontinued lenalidomide in the United States

Background: Patients with refractory multiple myeloma (MM) often progress through lines of therapy (LOTs) comprising multiple drug classes, which may impose severe economic burden. In this retrospective US claims database study, we examined healthcare resource utilization (HCRU) and costs of patients with MM who received 1 to 3 prior LOTs. Patients and Methods: Adults with MM from the IBM Truven MarketScan Claims Database (1 January 2011–22 April 2023) were required to be continuously enrolled in a medical benefit/pharmacy plan for ≥12 months before initial MM diagnosis date and to have received 1 to 3 LOTs (including receiving ≥1 proteasome inhibitor and immunomodulatory drug and receiving and discontinuing lenalidomide) after diagnosis date. Index dates (start of subsequent treatment after fulfilling inclusion criteria) occurred after 1 January 2018, to capture contemporary cost estimates. Primary outcomes included all-cause and MM-related healthcare costs and HCRU after index date. Results: The primary analysis included 338 patients with MM without post-index stem cell transplant (SCT), with a mean age of 61.1 years (55.3% male). During an average follow-up of 11.5 months, total all-cause healthcare costs averaged US $41,614 per patient per month. MM-related healthcare costs ($39,699) contributed 95% to total all-cause costs. Most MM-related monthly costs were attributed to drug/infusion costs (71%; $28,144). Sensitivity analyses that included patients with post-index SCT (N = 520) yielded similar results. Conclusions: Patients with MM with 1 to 3 prior LOTs experienced high economic burden largely attributable to MM-related treatment, highlighting the need for more cost-effective therapies.