Analysis of the impact on the budget of the appointment of cytogenetic studies before choosing first-line therapy for multiple myeloma.

Objective of the study: to analyze the budget impact of cytogenetic studies before prescribing first-line treatment regimens for multiple myeloma (MM). Materials and methods. The pharmacoeconomic study was performed using the method of “budget impact” analysis. This method allows estimating the financial consequences of introducing new medical technologies, diagnostic approaches or treatment methods within the established budget of the health care system. The main objective of the analysis was to study the changes in the financial burden on the health care system when cytogenetic studies are used in the treatment of multiple myeloma (MM). Results. A review of the literature has demonstrated that limited data are currently available on the clinical efficacy of regimens in the first-line treatment of MM, both in patients with normal and high cytogenetic risk. The budget impact analysis showed that if cytogenetic testing was performed on all patients before starting therapy, and VMP mode was given to 13,7% of patients with high cytogenetic risk among newly diagnosed patients as first-line therapy, instead of Rd or VRd modes, budget costs would increase by 11,01%. Conclusion. In summary, the conducted pharmacoeconomic study showed that the choice and prescription of first-line therapy based on cytogenetic study data (in particular, in case of high cytogenetic risk, the prescription of VMP instead of Rd or VRd) is a clinically effective and economically justified approach to the organization of medical care for adult patients with multiple myeloma in the territory of the Russian Federation. Despite the identified increase in federal budget expenditures when applying this strategy, the results of the study confirm that the use of a personalized approach can improve clinical outcomes and quality of life of patients, which justifies the additional costs.