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Also, we calculate cost\u2010effectiveness of treatment sequences commonly prescribed to predict effects and costs if patients had received a different treatment sequence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Real\u2010world data including patient and disease characteristics, treatment information and resource use were collected from 1054 elderly patients with MM. Patients received first\u2010line treatment during 2004\u20132007 (cohort 1) and 2008\u20132013 (cohort 2). The two cohorts were compared using a patient\u2010level simulation (PLS) model comprising regression models which used patient and disease characteristics to estimate time to next treatment and death. Effects and costs from cohort 2 were compared to 4 commonly prescribed real\u2010world sequences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Utilisation of novel agents was higher for cohort 2 compared to cohort 1. Modelled average OS for cohort 1 was 38\u00a0months (median 25) and total costs \u20ac44\u00a0200. OS for cohort 2 was 42\u00a0months (median 28) and total costs \u20ac69\u00a0017. The model identified potential OS gains if all patients were to be treated using combinations containing thalidomide, lenalidomide and bortezomib in that particular order. This sequence had, compared to real\u2010world treatment, the most favourable incremental cost\u2010effectiveness ratio, \u20ac24\u00a0618 per life year gained and \u20ac34\u00a0875 per QALY.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our patient\u2010level model enabled to study the effects and costs of entire treatment sequences and to compare real\u2010world treatment patterns over time. Increased utilisation of novel agents improved survival and increased costs for real\u2010world patients with MM in the Netherlands.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.12571","type":"journal-article","created":{"date-parts":[[2015,4,18]],"date-time":"2015-04-18T07:48:50Z","timestamp":1429343330000},"page":"198-208","source":"Crossref","is-referenced-by-count":31,"title":["A cost\u2010effectiveness analysis of real\u2010world treatment for elderly patients with multiple myeloma using a full disease model"],"prefix":"10.1111","volume":"96","author":[{"given":"Hedwig M.","family":"Blommestein","sequence":"first","affiliation":[{"name":"Department of Health Policy &amp; Management\/institute for Medical Technology Assessment Erasmus University Rotterdam The Netherlands"},{"name":"Comprehensive Cancer Organisation Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia G. 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