Cost-effectiveness analysis of daratumumab plus bortezomib, melphalan and prednisone for newly diagnosed multiple myeloma ineligible for stem cell transplantation

Abstract In this study, we established a Markov model to investigate the cost-effectiveness of bortezomib, melphalan, and prednisone with daratumumab (D-VMP) versus bortezomib, melphalan, and prednisone (VMP), in patients with newly diagnosed multiple myeloma (MM) who were ineligible for autologous stem-cell transplantation from the payers’ perspective of the United States. D-VMP gained an effectiveness of 4.60 QALY at a cost of $483,372.96, while VMP gained an effectiveness of 3.13 QALY at a cost of $123,270.32. The incremental effectiveness and cost of D-VMP versus VMP were 1.47 QALY and $360,102.64, yielding an incremental cost-effectiveness ratio of $244,967.78/QALY. Based on the data from ALCYONE trial and current price of daratumumab, addition of daratumumab to VMP is unlikely to be a cost-effective regimen in patients with newly diagnosed MM who were ineligible for autologous stem-cell transplantation.