Real-world cost-effectiveness of sequential therapy of in-class transition to ixazomib versus daratumumab for transplant-ineligible newly diagnosed multiple myeloma in China
Year: 2026
Type: article
Abstract: Aim: Expanding treatment options for transplant-ineligible newly diagnosed multiple myeloma (ndMM) in China has increased the need to identify treatment strategies that improve patient outcomes while using healthcare resources efficiently. This study evaluated the cost-effectiveness of in-class transition (iCT) to ixazomib, lenalidomide and dexamethasone (IRd) versus daratumumab, lenalidomide and dexamethasone (DRd) for transplant-ineligible ndMM from the perspective of the Chinese healthcare system. Materials & methods: A cost-effectiveness analysis was conducted using a Markov cohort model that simulated lifetime health benefits and medical costs for the two treatment modalities. Model inputs were estimated from best available real-world evidence in the literature and from public data sources. Deterministic, probabilistic and scenario sensitivity analyses were performed to assess uncertainty in model results. Results: In the base-case analysis, iCT IRd was projected to generate 0.580 additional quality-adjusted life years versus DRd (4.724 vs 4.144) and save lifetime medical costs by $7751. One-way sensitivity analysis indicated that cost-effectiveness was driven by uncertainty in model inputs related to treatment discontinuation and subsequent disease progression. Probabilistic sensitivity analysis estimated that iCT IRd had 79.2%, 88.0% and 91.3% probabilities of being cost-effective at willingness-to-pay thresholds of one, two and three-times China’s 2025 gross domestic product per capita per quality-adjusted life year, respectively. Conclusion: Based on best available real-world evidence, the iCT IRd modality could be cost-effective compared with the DRd modality for transplant-ineligible patients with ndMM in China. Future real-world studies are needed to confirm the projected outcomes.
Institutions: Shandong University, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Chaoyang Emergency Medical Center, Zhengzhou University, Henan Provincial People's Hospital, Beijing Jishuitan Hospital, Hebei Medical University, Fourth Hospital of Hebei Medical University, Takeda (Japan), Central South University, Toronto Public Health, University of Toronto, Xiangya Hospital Central South University, Tianjin Medical University General Hospital
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7221616330