ACQUISITION AND ADMINISTRATION COSTS OF BORTEZOMIB AND CARFILZOMIB TREATMENT FOR MULTIPLE MYELOMA IN FINLAND

OBJECTIVES: Information regarding intravenous and subcutaneous administration costs of multiple myeloma (MM) medications in Finland is scattered. Nevertheless, the need of acquisition and administration costs for health economic evaluations (HEE) of MM treatments is evident as these costs can be high. Furthermore, the first oral proteasome inhibitor (PI) treatment for MM, ixazomib, is available, potentially allowing reductions in the treatment acquisition and administration costs. We estimated the treatment acquisition and drug administration costs of infusion or subcutaneous PI treatments (carfilzomib, bortezomib) for MM in Finland. METHODS: Price tariffs of Finnish hospital districts are used as the basis of invoicing sent to health care service payer. Those prices were collected and analyzed to find costs for the relevant MM treatments. Furthermore, detailed inquiries were sent to all Finnish hospital districts to ensure the face validity of prices included. Two costing perspectives were applied: A] acquisition of treatment (until administered to the patient, i.e. both administration and drug cost included) and B] drug administration alone (administration included, drug costs excluded). RESULTS: 19 (95%) of the Finnish mainland hospital districts were included in the data collection. Relevant cost information was found from 15 (75%) districts (79% of the districts willing to participate). The mean acquisition cost was €1 923 (95%CI €1 540 - €2 305) [or $2 035] per acquisition. The mean administration cost alone was €270 (95%CI €189 - €351) [or $286] per administration (14% of the acquisition costs). CONCLUSIONS: The acquisition and administration of MM drugs given as infusions or subcutaneously in health care facilities cause significant and potentially avoidable costs. Due to the good coverage of providers' cost estimates, the present study provides useful cost estimate information for the future HEEs. Finally, novel oral medications including the first oral PI have significant potential in reducing the acquisition and administration costs.