PMID- 31377207
OWN - NLM
STAT- MEDLINE
DCOM- 20200824
LR  - 20200824
IS  - 2152-2669 (Electronic)
IS  - 2152-2669 (Linking)
VI  - 19
IP  - 10
DP  - 2019 Oct
TI  - Treatment Patterns and Clinical and Economic Outcomes in Patients With Newly 
      Diagnosed Multiple Myeloma Treated With Lenalidomide- and/or 
      Bortezomib-containing Regimens Without Stem Cell Transplant in a Real-world 
      Setting.
PG  - 645-655
LID - S2152-2650(18)31575-1 [pii]
LID - 10.1016/j.clml.2019.06.007 [doi]
AB  - BACKGROUND: Real-world data in patients with newly diagnosed multiple myeloma 
      (NDMM) are sparse. Using United States claims databases, we analyzed treatment 
      patterns, clinical outcomes, and health care utilization and costs in patients 
      receiving lenalidomide- and/or bortezomib-containing therapy. MATERIALS AND 
      METHODS: Patient claims were obtained from a large commercial and Medicare 
      database (October 2009 to May 2015). Patients with NDMM who received 
      lenalidomide- and/or bortezomib-containing therapy and did not receive stem cell 
      transplant (SCT) were analyzed. Duration of treatment (DOT), time to next 
      treatment (TTNT), and health care utilization and costs were evaluated. RESULTS: 
      Of 3075 patients, 1767 received doublet therapy (814 lenalidomide-dexamethasone 
      [Rd], 953 bortezomib-dexamethasone [Vd]) and 464 received triplet therapy (318 
      lenalidomide-bortezomib-dexamethasone [RVd], 146 
      cyclophosphamide-bortezomib-dexamethasone [CyBord]). Rd versus Vd resulted in 
      longer median DOT (12.0 vs. 5.9 months; P < .0001) and median TTNT (36.7 vs. 24.4 
      months; P = .0005). Year 1 costs were greater with Rd versus Vd (Delta = $14,964; P = 
      .0009), primarily owing to higher pharmacy costs; outpatient physician visits and 
      chemotherapy administration costs were lower. Median DOT (14.8 vs. 9.0 months; 
      P < .0001) and median TTNT (35.7 vs. 22.3 months; P = .0007) were longer with RVd 
      versus CyBord; year 1 costs were comparable. CONCLUSIONS: In this study of 
      patients with NDMM ineligible for transplant, the median duration of therapy was 
      approximately 70% of that in clinical trial observations. Lenalidomide therapy 
      versus Vd and CyBord resulted in longer DOT, which correlated with longer TTNT, 
      and higher pharmacy costs, which were partially offset by lower outpatient and 
      chemotherapy administration costs.
CI  - Copyright (c) 2019. Published by Elsevier Inc.
FAU - Chari, Ajai
AU  - Chari A
AD  - Department of Medicine, Hematology and Medical Oncology, Mount Sinai Hospital, 
      New York, NY. Electronic address: ajai.chari@mountsinai.org.
FAU - Parikh, Kejal
AU  - Parikh K
AD  - Celgene Corporation, Summit, NJ.
FAU - Ni, Quanhong
AU  - Ni Q
AD  - Celgene Corporation, Summit, NJ.
FAU - Abouzaid, Safiya
AU  - Abouzaid S
AD  - Celgene Corporation, Summit, NJ.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190618
PL  - United States
TA  - Clin Lymphoma Myeloma Leuk
JT  - Clinical lymphoma, myeloma & leukemia
JID - 101525386
RN  - 0 (Immunologic Factors)
RN  - 69G8BD63PP (Bortezomib)
RN  - 7S5I7G3JQL (Dexamethasone)
RN  - F0P408N6V4 (Lenalidomide)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Bortezomib/administration & dosage/*therapeutic use
MH  - Cost of Illness
MH  - Dexamethasone/administration & dosage
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Immunologic Factors/administration & dosage/therapeutic use
MH  - Lenalidomide/administration & dosage/*therapeutic use
MH  - Male
MH  - Medicare/*economics/statistics & numerical data
MH  - Middle Aged
MH  - Multiple Myeloma/*drug therapy/economics
MH  - Outcome Assessment, Health Care/*economics/statistics & numerical data
MH  - United States
OTO - NOTNLM
OT  - Doublet therapy
OT  - Health care claims analysis
OT  - Multiple myeloma
OT  - Triplet therapy
OT  - United States
EDAT- 2019/08/05 06:00
MHDA- 2020/08/25 06:00
CRDT- 2019/08/05 06:00
PHST- 2018/11/30 00:00 [received]
PHST- 2019/04/02 00:00 [revised]
PHST- 2019/06/07 00:00 [accepted]
PHST- 2019/08/05 06:00 [pubmed]
PHST- 2020/08/25 06:00 [medline]
PHST- 2019/08/05 06:00 [entrez]
AID - S2152-2650(18)31575-1 [pii]
AID - 10.1016/j.clml.2019.06.007 [doi]
PST - ppublish
SO  - Clin Lymphoma Myeloma Leuk. 2019 Oct;19(10):645-655. doi: 
      10.1016/j.clml.2019.06.007. Epub 2019 Jun 18.