The Economic Burden of Multiple Myeloma. Definition of a Model for the Patients Cost Forecast

The aim of this study was to evaluate the healthcare costs in a single center population of myeloma patients (pts), trying to develop a model for a cost prevision. A cohort of 387 multiple myeloma (MM) patients, diagnosed at Policlinico San Matteo in Pavia from 2002 to 2014, was analyzed grouping patients in transplant (223 pts) or not transplant eligible (164 pts). After a descriptive statistic, the benchmark model the Ordinary Least Squared (OLS) and, different variations of the Generalized Linear Models (GLM) were adopted. The total cost per patient was on average around 28,500€ for not transplant eligible patients and around 87,000€ for the eligible ones. The analysis highlighted four determinants useful in building a model to forecast of expenditure: age, bortezomib, lenalidomide, number of lines of therapies. The two most important determinants per patient expenditure was represented both by the novel agents and the number of total line of therapies, which entails a higher number of dosages and a higher need of accesses to the hospital. Furthermore, in patients eligible to transplant their marginal costs increased over time probably due to the hospitalization costs and the transplant procedure itself. In conclusion, using a GLM model, we identified in our cohort four determinants useful in building a model of prevision of expenditure for MM patients. Although, the analysis have been performed in a particular setting in a single hospital, the model can be applied to any scenario of patients.