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Cost-effectiveness of lenalidomide

Bone Marrow Transplantation volume 55, pages 853–854 (2020)Cite this article

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Firstly, the authors wish to thank the writer for the comments made to the article on the cost-effectiveness analysis of the treatment with lenalidomide in patients who have undergone autologous hematopoietic cell transplantation [1]. Our research team believe that it would have been ideal to base the pharmaco-economic study on long-term efficacy results, in order to reduce uncertainty and ensure maturity of results. However, it is important to bear in mind that projecting the effects over time does not improve efficiency, since costs would increase simultaneously. The results shown in Table 3, with data extrapolated to 20 years, continue to show a cost-effectiveness ratio higher than the threshold established in Spain and in the vast majority of European countries.

Like Dhanasiri, we believe that treatment with lenalidomide has proven (in clinical trials IFM 2005-02 and CALGB 100104) to increase progression-free survival compared with no maintenance treatment. But, as mentioned in the discussion section, the current cost of treatment makes it inefficient for the Spanish National Health System and presumably for many other health systems. In this regard, and as shown in the sensitivity analyses, the analyses based on a reduction in the price of lenalidomide yield incremental cost-effectiveness ratios similar to those described by Uyl-de Groot (2019) [2]. It should be pointed out that this communication failed to provide sufficient information on methodology and other details for establishing the reasons for the observed differences.

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References

  1. Olry de Labry-Lima A, Gimeno-Ballester V, Ríos-Tamayo R, Epstein D, Matas Hoces A, Ríos Sanchez E, et al. Cost-effectiveness of lenalidomide maintenance in patients with multiple myeloma who have undergone autologous transplant of hematopoietic progenitor cells. Bone Marrow Transplant. 2019. https://doi.org/10.1038/s41409-019-0574-5.

  2. Uyl-de Groot CA, Ramsden R, Boersman J, Zweegman S, Dhanasiri S. Lenalidomide as maintenance treatment for patients with newly diagnosed multiple myeloma post-autologous stem cell transplantation: a pharmacoeconomic assessment in the Netherlands. Blood. 2018;132. abstract 3555.

  3. Informe de Posicionamiento Terapéutico de lenalidomida (Revlimid®) en mantenimiento en mieloma múltiple. https://www.aemps.gob.es/medicamentosUsoHumano/informesPublicos/docs/IPT-lenalidomida-Revlimid-mantenimiento-mieloma-multiple.pdf. (viewd 24 Oct 2019).

  4. European public assessment report for Revlimid® (lenalidomida). http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Assessment_Report_-_Variation/human/000717/WC500225259.pdf. (viewed Oct 2019).

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Authors and Affiliations

  1. Escuela Andaluza de Salud Pública, Granada, Spain

    Antonio Olry de Labry Lima

  2. Centro de Investigación en Salud Pública CIBERESP, Madrid, Spain

    Antonio Olry de Labry Lima

  3. Institute of Biomedical Research (ibs), University Hospitals of Granada/University of Granada, Granada, Spain

    Antonio Olry de Labry Lima

  4. Centro Andaluz de Información del Medicamento (CADIME), Granada, Spain

    Antonio Matas Hoces

  5. Service of Pharmacy, University Hospital Miguel Servet, Zaragoza, Spain

    Vicente Gimeno Ballester

  6. Service of Pharmacy, Puerto Real University Hospital, Puerto Real, Cadiz, Spain

    Esmeralda Ríos Sánchez & Emilio Jesús Alegre del Rey

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  1. Antonio Olry de Labry Lima
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  2. Antonio Matas Hoces
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  3. Vicente Gimeno Ballester
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  4. Esmeralda Ríos Sánchez
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  5. Emilio Jesús Alegre del Rey
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Correspondence to Antonio Olry de Labry Lima.

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Olry de Labry Lima, A., Matas Hoces, A., Gimeno Ballester, V. et al. Cost-effectiveness of lenalidomide. Bone Marrow Transplant 55, 853–854 (2020). https://doi.org/10.1038/s41409-020-0787-7

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