Medication use evaluation of the financial and clinical implications of ixazomib compared to bortezomib in the outpatient setting

J Oncol Pharm Pract. 2021 Mar;27(2):279-282. doi: 10.1177/1078155220915963. Epub 2020 Apr 11.

Abstract

In the past decade, several new therapies have been approved for use in multiple myeloma, including the novel oral agent, ixazomib. Ixazomib, like bortezomib and carfilzomib, is a proteasome inhibitor, a class of agents that are a mainstay of treating multiple myeloma in both the frontline and relapsed settings. Ixazomib is administered orally and offers many potential advantages over the subcutaneous or intravenous administration of bortezomib. In this single-center, retrospective medication use evaluation, adult patients with multiple myeloma receiving either ixazomib or bortezomib in the outpatient setting were assessed to evaluate financial implications and tolerability. A total of 28 patients were included. The total wholesale acquisition cost for one cycle of ixazomib was $9942, and $6412 for bortezomib. Average reimbursement per cycle was $9205 for ixazomib and $5664 for bortezomib. Secondarily, the incidence of interruption in therapy was evaluated. Ixazomib was associated with a slightly higher incidence of interruption compared to bortezomib, 42.9% and 35.7%, respectively. It is notable that ixazomib has similar drug reimbursement rates to bortezomib, but slightly higher rates of interruption in therapy. In conclusion, if tolerable for the patient, ixazomib may offer a financially acceptable alternative for the treatment of multiple myeloma.

Keywords: Cost; ixazomib; multiple myeloma; ninlaro; reimbursement.

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / economics*
  • Antineoplastic Agents / therapeutic use
  • Boron Compounds / administration & dosage
  • Boron Compounds / economics*
  • Boron Compounds / therapeutic use
  • Bortezomib / administration & dosage
  • Bortezomib / economics*
  • Bortezomib / therapeutic use
  • Drug Costs
  • Female
  • Glycine / administration & dosage
  • Glycine / analogs & derivatives*
  • Glycine / economics
  • Glycine / therapeutic use
  • Humans
  • Injections, Subcutaneous
  • Insurance, Health, Reimbursement
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy*
  • Retrospective Studies

Substances

  • Antineoplastic Agents
  • Boron Compounds
  • Bortezomib
  • ixazomib
  • Glycine