Productivity losses in patients with newly diagnosed multiple myeloma following stem cell transplantation and the impact of maintenance therapy

• Published in: European journal of haematology 2019-10, Vol.103 (4), p.393-401
• Main Authors: Jackson, Graham, Galinsky, Jayne, Alderson, David E. C., D'Souza, Vijay K., Buchanan, Vanessa, Dhanasiri, Sujith, Walker, Simon
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Autografts; autologous transplantation; Cross-Sectional Studies; Efficiency, Organizational; Europe - epidemiology; Female; health services accessibility; Hematopoietic Stem Cell Transplantation; Humans; Maintenance Chemotherapy; Male; Middle Aged; Models, Theoretical; Multiple myeloma; Multiple Myeloma - diagnosis; Multiple Myeloma - epidemiology; Multiple Myeloma - therapy; Original; Patients; Polls & surveys; Population Surveillance; Productivity; Quality of life; Remission; return to work; Socioeconomic Factors; Stem cell transplantation; Stem cells; surveys and questionnaires; Treatment Outcome; Young Adult
• ISSN: 0902-4441; 1600-0609
• DOI: 10.1111/ejh.13298

Objective This study examined productivity losses in European patients with newly diagnosed multiple myeloma (NDMM) undergoing autologous stem cell transplantation (ASCT), to better understand and model the impact of NDMM and lenalidomide maintenance therapy on productivity from a patient and societal perspective. Methods A cross‐sectional online patient survey was conducted across the UK, Germany, France, Spain and Italy. A partitioned survival model was used to estimate productivity loss and the impact of maintenance therapy, using human capital (HC) and friction cost approaches. Results Of the 115 eligible survey respondents, 76.5% were economically active at the time of diagnosis and highlighted return to work as an important factor affecting their quality of life; only 39.1% of respondents were economically active post‐ASCT. HC analyses estimated average total productivity losses per ASCT patient at EUR 290,601 over a 20‐year period. Modelling the impact of maintenance therapy alone for these patients reduced average productivity losses by just over 10%. Conclusion Patients with NDMM aspire to engage in productive lives post‐ASCT, but most are unable to do so. Access to treatments extending remission and supporting engagement in a productive life can have a positive impact both for patients and wider society.