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BURDEN OF ILLNESS ASSOCIATED WITH MULTIPLE MYELOMA
Author(s): ,
Moushmi Singh
Affiliations:
ICON Health Economics,ICON,Abingdon,United Kingdom
,
Gemma Kay
Affiliations:
ICON Health Economics,ICON,Abingdon,United Kingdom
,
John O'Rourke
Affiliations:
ICON Health Economics,ICON,Abingdon,United Kingdom
,
James Eaton
Affiliations:
ICON Health Economics,ICON,Abingdon,United Kingdom
,
Deborah Berg
Affiliations:
Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited,Cambridge,United States
,
Tomas Skacel
Affiliations:
Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited,Cambridge,United States
,
Mehul Jhaveri
Affiliations:
Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited,Cambridge,United States
,
Brian Seal
Affiliations:
Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited,Cambridge,United States
Huamao Mark Lin
Affiliations:
Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited,Cambridge,United States
(Abstract release date: 05/19/16) EHA Library. Singh M. 06/09/16; 132992; E1443 Disclosure(s): Singh M, Kay G, O’Rourke J, Eaton J are employees of ICON. Berg D, Skacel T, Jhaveri M, Seal B, Lin HM are employees of Millennium Pharmaceuticals. The poster and the background research were funded by Millennium Pharmaceuticals.
Mrs. Moushmi Singh
Mrs. Moushmi Singh
Contributions
Abstract
Abstract: E1443

Type: Eposter Presentation

Background
Multiple myeloma (MM) is a cancer of plasma cells originating in bone marrow and affecting multiple organs. It accounts for 0.8% of all new cancers and is the 2nd most common haematological cancer in the US. It is an incurable disease with an average survival of 4-5 years. Median age at diagnosis is approximately 70 years.MM poses humanistic and economic burden by affecting the health related quality of life (HRQoL) of the patients and/or carers and by impacting healthcare budgets, respectively.

Aims
To review the humanistic and economic burden of MM.

Methods
Two targeted literature reviews were performed; one each for humanistic and economic burden. MEDLINE®, Embase and PubMed (for e-publications ahead of print) were searched to identify relevant publications from 2005 to date. EconLit and NHS Economic Evaluations Database (EED) were searched to identify articles specific to the economic burden. Search terms included disease, QoL and economic terms.

Results
A total of 1029 abstracts for the humanistic burden review and 629 abstracts for economic burden review were identified and screened. Twenty articles were included in the humanistic burden and 18 in the economic burden review.MM is associated with substantial burden of illness. Patients experience a high symptom burden that adversely affects their HRQoL. Bone pain and fatigue are the most common symptoms of the disease. Patients exhibit impaired physical, role, cognitive, emotional and social functioning. Coping with the disease and managing its consequences including loss of independence and being vigilant to prevent incidences of fracture emerge as the predominant factors of the disease. The causes of disease burden are similar in newly diagnosed and/or RRMM patients, with both populations experiencing significant symptom burden which adversely affects their HRQoL. However, the burden in RRMM patients worsens with disease progression such as increased bone pain, fractures and fatigue. Additionally, there is considerable burden on caregivers who report restricted social, leisure, professional/work activities.MM also imposes significant economic burden. The total cost varies depending on whether the disease presents as asymptomatic or symptomatic and by line of treatment. Non-drug costs, which include hospitalisation, autologous stem cell transplant (ASCT), adverse events and ambulatory costs account for approximately 54% of the total cost. Patients treated with novel agents or ASCT and patients who experience skeletal-related events incurred the highest spend for hospitalisation. Some adverse events associated with novel agent treatment required hospitalisation; anaemia and neuropathy were most common. These were associated with a mean length of stay of 9 to 14 days in R/R patients depending on the novel agent received.Costs of productivity loss due to MM were evaluated in one study. Patients who undergo ASCT incurred the highest costs of productivity loss based on working days and hours lost by the patients and caregivers, respectively. Improved outcomes associated with ASCT were not assessed in this study.

Conclusion
MM poses significant humanistic and economic burden; which increases with disease progression and subsequent lines of therapy.HRQoL in these patients diminishes with symptom severity and disease progression. The total cost of illness is driven by treatment line and choice. These findings warrant the need for more effective therapy with better safety profile delaying disease progression, reducing symptoms and improving patient’s outcome.

Session topic: E-poster

Keyword(s): Multiple myeloma, Quality of life
Abstract: E1443

Type: Eposter Presentation

Background
Multiple myeloma (MM) is a cancer of plasma cells originating in bone marrow and affecting multiple organs. It accounts for 0.8% of all new cancers and is the 2nd most common haematological cancer in the US. It is an incurable disease with an average survival of 4-5 years. Median age at diagnosis is approximately 70 years.MM poses humanistic and economic burden by affecting the health related quality of life (HRQoL) of the patients and/or carers and by impacting healthcare budgets, respectively.

Aims
To review the humanistic and economic burden of MM.

Methods
Two targeted literature reviews were performed; one each for humanistic and economic burden. MEDLINE®, Embase and PubMed (for e-publications ahead of print) were searched to identify relevant publications from 2005 to date. EconLit and NHS Economic Evaluations Database (EED) were searched to identify articles specific to the economic burden. Search terms included disease, QoL and economic terms.

Results
A total of 1029 abstracts for the humanistic burden review and 629 abstracts for economic burden review were identified and screened. Twenty articles were included in the humanistic burden and 18 in the economic burden review.MM is associated with substantial burden of illness. Patients experience a high symptom burden that adversely affects their HRQoL. Bone pain and fatigue are the most common symptoms of the disease. Patients exhibit impaired physical, role, cognitive, emotional and social functioning. Coping with the disease and managing its consequences including loss of independence and being vigilant to prevent incidences of fracture emerge as the predominant factors of the disease. The causes of disease burden are similar in newly diagnosed and/or RRMM patients, with both populations experiencing significant symptom burden which adversely affects their HRQoL. However, the burden in RRMM patients worsens with disease progression such as increased bone pain, fractures and fatigue. Additionally, there is considerable burden on caregivers who report restricted social, leisure, professional/work activities.MM also imposes significant economic burden. The total cost varies depending on whether the disease presents as asymptomatic or symptomatic and by line of treatment. Non-drug costs, which include hospitalisation, autologous stem cell transplant (ASCT), adverse events and ambulatory costs account for approximately 54% of the total cost. Patients treated with novel agents or ASCT and patients who experience skeletal-related events incurred the highest spend for hospitalisation. Some adverse events associated with novel agent treatment required hospitalisation; anaemia and neuropathy were most common. These were associated with a mean length of stay of 9 to 14 days in R/R patients depending on the novel agent received.Costs of productivity loss due to MM were evaluated in one study. Patients who undergo ASCT incurred the highest costs of productivity loss based on working days and hours lost by the patients and caregivers, respectively. Improved outcomes associated with ASCT were not assessed in this study.

Conclusion
MM poses significant humanistic and economic burden; which increases with disease progression and subsequent lines of therapy.HRQoL in these patients diminishes with symptom severity and disease progression. The total cost of illness is driven by treatment line and choice. These findings warrant the need for more effective therapy with better safety profile delaying disease progression, reducing symptoms and improving patient’s outcome.

Session topic: E-poster

Keyword(s): Multiple myeloma, Quality of life

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