OBJECTIVES: Elranatamab-bcmm is a bispecific antibody indicated for the treatment of adult patients with RRMM who have received at least four prior lines of therapy including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody. Understanding the budget impact of introducing elranatamab in this population is of key interest to US payers. This research estimated the budget impact of introducing elranatamab-bcmm in US commercial and Medicare health plan settings.

METHODS: A budget impact model was developed to assess the impact of elranatamab-bcmm on health care costs in a hypothetical 1-million-member commercial and Medicare health insurance plan respectively over a 3-year period. Epidemiology data was obtained from the SEER database and a large US real world study (Nikolaou 2022). Key clinical variables included treatment duration, progression free- and overall survival, and adverse event (AE) incidence. Cost associated with drug acquisition (primary- and subsequent treatments), administration, monitoring, medical resources use, grade 3/4 AEs, and all grade cytokine release symptoms (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) were incorporated. Model inputs were sourced from clinical trial data, US government data bases, and published literature. Total and per member per month (PMPM) costs were assessed. One-way sensitivity analyses (OWSA) assessed uncertainty around model inputs.

RESULTS: An estimated 14 (Commercial) and 60 (Medicare) RRMM patients per year would be eligible for treatment with elranatamab-bcmm. The availability of elranatamab resulted in total budget impact of $527,519; $0.04 PMPM (Commercial) and $2,240,704; $0.19 PMPM (Medicare) over 3 years. OWSA indicated results were most sensitive to share of patients <65 years, and elranatamab-bcmm drug cost and relative dose intensity.

CONCLUSIONS: Treatment with elranatamab-bcmm in RRMM is estimated to result in a minimal to small budget impact over a 3-year period, partly explained by a small eligible patient population.