Abstract
Treatment for multiple myeloma (MM) can involve apheresis to mobilize hematopoietic stem cells for later autologous stem cell transplantation (ASCT), which can become costly over time. This retrospective claims database study examined healthcare resource use and medical costs associated with plerixafor, a selective CXCR4 inhibitor that mobilizes hematopoietic stem cells and minimizes apheresis times. Medical data were sampled from Japanese MM patients between April 2017 and September 2019, after the Japanese launch of plerixafor. The study population (190 plerixafor users and 180 non-users) was identified from the Medical Data Vision database, and further stratified into those using granulocyte-colony stimulating factor in monotherapy or in combination with cyclophosphamide to trigger apheresis. A descriptive comparison of patient characteristics, healthcare resource use, and medical costs across the mobilization and ASCT phases indicated plerixafor is associated with higher average total medical costs. However, plerixafor-treated patients received fewer concomitant medications and spent less time in apheresis than non-users. A comparison of non-users with a similar analysis conducted pre-plerixafor launch (2013–2017) showed general improvements to treatment independent of plerixafor. The results of this research can inform guidelines for the role of plerixafor in balancing cost-effectiveness and drug efficacy in MM treatment.
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Acknowledgements
The study was funded by Sanofi K.K (Tokyo, Japan) and consigned to Syneos Health (Tokyo, Japan) for study design and analysis. Syneos Health commissioned MIMS Pte Ltd (Hong Kong, China) for medical writing and editorial support. Professional writing assistance, editorial support, and graphical design were provided by MIMS Pte Ltd (mims.com) and Stephen Heap (drstevilphd.com), and funded by Sanofi K.K.
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S Iida has received a research grant and compensation as a member of the scientific advisory board of Sanofi K.K during the production of this article; outside the submitted work; has received grants and personal fees from Janssen, Celgene, Takeda, Ono, Daiichi Sankyo, Bristol-Myers Squibb, and personal fees from GlaxoSmithKline, AbbVie, Chugai, and Kyowa Kirin. T Ishida has received compensation as a member of the scientific advisory board of Sanofi K.K, and personal fees from Takeda, Ono, Bristol Myers Squibb, and Janssen during the conduct of this study. S Teramukai reports payments outside the submitted article through grants from Nippon Boehringer Ingelheim and personal fees from Daiichi Sankyo, Sanofi K.K., Takeda, Bayer Yakuhin, Sysmex, Chugai, Solasia, Nipro, Atworking, NapaJen Pharma, and Gunze. T Teshima has received compensation as a member of the scientific advisory board of Sanofi K.K during the conduct of this study; and outside the submitted work has received grants, personal fees, and non-financial support from Novartis, grants and personal fees from Kyowa Kirin, grants from Chugai, Astellas, Teijin Pharma, Fuji Pharma, Nippon Shinyaku, personal fees from Merck Sharp & Dohme, Takeda, Pfizer, Bristol-Myers Squibb, and non-financial support from Janssen. H Shirai, R Kanamori, and Y Tajima are employees of Sanofi K.K. B Crawford and J Yi are employees of Syneos Health. T Miyamoto reports no conflicts of interest.
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Iida, S., Ishida, T., Miyamoto, T. et al. MEdical Database AnaLysIS of Japanese multiple myeloma patienTs with apheresis #2 (MEDALIST-2): the impact of plerixafor use on costs and healthcare resources during mobilization and stem cell transplantation. Int J Hematol 116, 411–422 (2022). https://doi.org/10.1007/s12185-022-03356-2
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DOI: https://doi.org/10.1007/s12185-022-03356-2