ICER casts doubt on cost-effectiveness of newer MM drugs

In a draft evidence Kyprolis carfilzomib, Empliciti elotuzumab and Ninlaro ixazomib, all in combination with Revlimid lenalidomide and dexamethasone, "provide an incremental or better net health benefit for both second-line and third-line or subsequent therapy" compared with Revlimid plus dexamethasone alone.

But the institute said the incremental cost-effectiveness ratios for the three drugs were "well above commonly-cited thresholds" for cost-effectiveness, typically $50,000-$150,000 per quality-adjusted life year (QALY) gained. It estimated a cost-effectiveness ratio of $267,464 per QALY for Kyprolis, $255,498 for Empliciti, and $390,639 for Ninlaro as second-line therapy. As third-line therapy, the drugs' cost-effectiveness ratios were $312,840 per QALY for Kyprolis, $289,425 for Empliciti and $435,855 for Ninlaro. ...