The Impact of Bridging Agents on Costs Associated with CAR T Therapy for Patients with Relapse/Refractory Multiple Myeloma: Results of a Micro-costing Analysis
Introduction/Background/Significance: CAR T therapy is a treatment option for patients with relapse/refractory multiple myeloma (RRMM), however optimizing treatment outcomes may depend on the implementation of appropriate bridging treatment following cell apheresis. Previous research has reported differences in CAR T progression-free survival (PFS) based on different bridging treatment. This analysis seeks to understand the economic impact of bridging therapy based on observed idecabtagene vicleucel (ide-cel) outcomes.
Materials and Methods/Case Presentation/Objective: Costs associated with the administration of ide-cel were collected from public sources and published literature, including drug acquisition costs for ide-cel, pre-, peri-, and post- infusion costs. Adverse event costs were included for all grade CRS or neurologic toxicities and ‚â•3 grade for all other events. All costs were adjusted to 2025 US dollars. The PFS for ide-cel by bridging treatment was applied from Afrough et al. Cost per month of PFS gained by bridging treatment by patient were calculated for selinexor, proteasome inhibitor, alkylator, and IMiD -based treatments.
Results/Description/Main Outcome Measures: The estimated cost per month of PFS by bridging treatment on a per patient basis was $70,907, $108,075, $106,415, and $57,682 for selinexor, proteasome inhibitor, alkylator, and IMiD -based treatments, respectively, assuming all patients were treated inpatient and allowing for 12 months of follow-up.
Conclusions: This analysis demonstrates the importance of bridging treatment selection on clinical and economic outcomes. Further studies are needed to identify approaches to holding and bridging treatments to further optimize T cell redirecting therapies such as ide-cel.
