OBJECTIVES: Elranatamab-bcmm and teclistamab-cqyv are bispecific antibodies granted FDA accelerated approval for the treatment of adult patients with RRMM based on high and durable response rates. While clinical studies showed that median progression-free survival (PFS) was 17.2 months with elranatamab-bcmm and 11.3 months with teclistamab-cqyv, economic impact associated with these treatments are absent. A cost calculator was developed to estimate the cost of treating patients with elranatamab-bcmm vs teclistamab-cqyv.

METHODS: Inputs were based on clinical data from MagnetisMM-3 (Cohort A) and MajesTec-1, US prescribing information, US government databases, and published literature. The comparison included drug costs adjusted for relative dose intensity (RDI) and switching to every 2-week administration (elranatamab). Mean treatment duration (TD) was estimated using exponential extrapolation of median TD from clinical trials. Costs of monitoring, medical resource use (MRU), grade 3/4 adverse events (AEs) and all grade cytokine release syndrome (CRS) and ICANs neurotoxicity were incorporated. Total cost of care was measured over a 12-month period, per patient per month (PPPM), and per median month of PFS.

RESULTS: Mean total cost per patient was lower with elranatamab-bcmm ($390,215; PPPM: $32,518) compared with teclistamab-cqyv ($549,317; PPPM: $45,776). Drug acquisition cost was lower with elranatamab-bcmm ($322,404 vs $459,023), explained by no drug wastage for treatment dose, 2-week dosing, shorter TD (8.01 vs 12.26 months), and lower RDI. Lower MRU costs with elranatamab-bcmm ($22,942 vs $40,571) was primarily explained by fewer hospitalization days (5 vs 9) during step-up dosing. Cost of AEs were similar between the treatments ($44,869 vs $49,722). Cost per median month of PFS was $22,687 for elranatamab-bcmm and $48,612 for teclistamab-cqyv.

CONCLUSIONS: This analysis suggests lower total cost of care and cost per median month of PFS with elranatamab-bcmm compared with teclistamab-cqyv. Updated evaluations, including adjustments for differences in patient characteristics, are needed to further support cost-reducing strategies.