MRD testing for patients with multiple myeloma who are receiving maintenance therapy is cost effective when compared with no MRD testing, according to a model developed by German researchers and published online in September in Oncology and Therapy. The article and its publication costs were funded by Adaptive Biotechnologies, which manufactures the clonoSEQ® next-generation sequencing MRD assay.
The model assumed that all patients were treated as outpatients and had non-refractory disease after induction therapy, that MRD testing was performed with clonoSEQ®, and that patients were tested every 6 months, in accordance with European Medicines Agency recommendations. Therapies included in the model were lenalidomide as maintenance therapy and carfilzomib, lenalidomide, and dexamethasone as second-line therapy. The calculated health outcomes were overall and progression-free survival.
Cost input data were drawn from the literature and publicly available data on the cost to the German health care system of the drugs used in treatment and the costs of outpatient services and specimen collection. All other costs, such as the cost of stem cell transplantation and the possible influence of MRD testing on therapeutic decisions, were excluded. Costs for MRD testing compared with no MRD testing were calculated for time horizons of 1, 3, and 10 years.
The analysis concluded that MRD testing reduced mean incremental costs per patient by 18,000 euros (about $US 21,000) per year and saved a total of about 80,000 euros (about $US 93,000) after 10 years by reducing the prolongation of ineffective or unnecessary treatment.
- Walzer S, Krenberger S, Vollmer L, et al. A Cost Impact Analysis of clonoSEQ® as a Valid and CE-Certified Minimal Residual Disease (MRD) Diagnostic Compared to No MRD Testing in Multiple Myeloma in Germany. Oncol Ther. 2021. https://doi.org/10.1007/s40487-021-00169-x