Talquetamab Cost-Effective Breakthrough for RRMM

Data on talquetamab-tgvs (Talvey; Janssen) presented at the Academy of Managed Care Pharmacy 2024 annual meeting show the bispecific GRPC5D-directed CD3 T-cell engager is effective when administered to patients with relapsed/refractory multiple myeloma (RRMM) who have failed at least 4 prior lines of treatment, and that the cost to give the treatment is lower per responding patient compared with usual care.¹

For this analysis, the total cost of care with talquetamab encompassed the cost of the treatment itself—based on an average US patient weight in MM of 85 kg—inpatient cost, adverse event management cost after step-up hospitalization, outpatient administrative and supportive care cost, and subsequent therapy cost. Treatment duration was based on progression-free survival.

The FDA granted Janssen an accelerated approval for talquetamab on August 9, 2023, for use among this patient population, with failed prior therapies that include a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody. Talquetamab had previously received priority review, breakthrough designation, and orphan drug designation.²

In this most recent analysis, the authors reiterated that most patients with MM, especially RRMM, endure multiple treatments and disease relapses, resulting in extreme clinical and economic burdens from poor disease control. However, talquetamab shows great promise in filling a treatment void for patients with severely refractory RRMM due to its previously demonstrated high overall response rate (ORR) among this population. Data are lacking, however, on its cost-effectiveness. For comparison with usual care, they used cost data for weekly and biweekly talquetamab from a recent study conducted among patients with RRMM and 4 prior lines of therapy³ and ORR data on talquetamab and physician’s choice from the MonumenTAL-1 (NCT03399799) and LocoMMotion (NCT04035226) studies, respectively.

For weekly talquetamab administration, the total costs of care for 6 months of treatment were $327,987, and for 12 months, $521,567. Biweekly administration saw corresponding costs of $341,217 and $551,350. For usual care at these time points, the care costs were $217,996 and $435,993.

Per responder, 6-month costs were $442,627 for weekly dosing and $446,781 for biweekly dosing, and 12-month costs were $703,869 and $754,241, respectively, compared with $764,900 and $1,529,800 for usual care after 6 and 12 months.

A final analysis that considered costs per additional responder produced figures of $241,207 and $285,233 for 6 months of weekly or biweekly talquetamab, respectively, and $187,663 and $267,031, respectively, for 12 months of treatment.

The investigators concluded that talquetamab is both effective and cost-effective among patients who have RRMM, with superior per-responder costs compared with usual care.

References

1. Lee H, Le H, Zhang X. Cost-per-responder analysis for patients with relapsed or refractory multiple myeloma treated with talquetamab compared with usual care. Poster presented at: Academy of Managed Care Pharmacy 2024 annual meeting; April 15-18, 2024; New Orleans, LA. Presentation C33.

2. FDA grants accelerated approval to talquetamab-tgvs for relapsed or refractory multiple myeloma. News release. FDA. August 9, 2023. Accessed April 22, 2024. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-accelerated-approval-talquetamab-tgvs-relapsed-or-refractory-multiple-myeloma

3. Martin T, Krishnan A, Yong K, et al. Comparative effectiveness of ciltacabtagene autoleucel in CARTITUDE-1 versus physician's choice of therapy in the Flatiron Health multiple myeloma cohort registry for the treatment of patients with relapsed or refractory multiple myeloma. EJHaem. 2021;3(1):97-108. doi:10.1002/jha2.312