The European Journal of Health Economics

, Volume 14, Issue 3, pp 507–514

Lenalidomide for multiple myeloma: cost-effectiveness in patients with one prior therapy in England and Wales

  • Ruth E. Brown
  • Sean Stern
  • Sujith Dhanasiri
  • Steve Schey
Original Paper



To determine the cost effectiveness of lenalidomide plus dexamethasone (LEN/DEX) versus DEX alone in managing multiple myeloma (MM) patients who have failed one prior therapy.

Materials and Methods

An individual simulation model was designed to capture the costs and outcomes of LEN/DEX versus DEX therapy in relapsed refractory MM patients. MM009/010 efficacy data were adjusted for treatment cross-over and extrapolated to patient lifetime. Resource use for MM disease progression and adverse events were obtained from expert physicians and costed from the perspective of the National Health Service (England and UK) and included a patient access scheme for LEN. Utility values were obtained from published literature.


The simulation model estimated an incremental improvement in time to progression of 9.5 months, an additional 3.2 life-years, and 2.2 quality adjusted life years (QALY) for LEN/DEX compared to DEX alone. Including the costs of therapy with the patient access scheme, adverse events, and disease follow-up, the incremental cost effectiveness ratio was £30,153/QALY for LEN/DEX compared to DEX alone in MM patients who have failed one prior therapy.


LEN/DEX is a cost effective oncology therapy from the perspective of the NHS for MM patients with one prior treatment.


Lenalidomide Multiple myeloma Cost effectiveness Dexamethasone Patient access scheme 

JEL Classification



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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Ruth E. Brown
    • 1
  • Sean Stern
    • 1
  • Sujith Dhanasiri
    • 2
  • Steve Schey
    • 3
  1. 1.United BioSource CorporationBethesdaUSA
  2. 2.Celgene Ltd. (UK and Ireland)Stockley ParkUK
  3. 3.King’s College HospitalLondonUK

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