{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T10:00:42Z","timestamp":1771927242838,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2013,1,1]],"date-time":"2013-01-01T00:00:00Z","timestamp":1356998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Millennium Pharmaceuticals, Inc."},{"name":"Janssen Global Services"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The outlook for transplant-ineligible multiple myeloma patients has improved enormously over recent years with the incorporation of new agents into standard regimens. Novel regimens combine melphalan and prednisone (MP) with bortezomib (VMP), with thalidomide (MPT), and with lenalidomide with (MPR-R) and without (MPR) lenalidomide maintenance. The efficacy, safety, and cost-effectiveness of these regimens have not yet been compared; therefore, we conducted a pharmacoeconomic analysis using data from randomized controlled trials versus MP.<\/jats:p>\n               <jats:p>Using a Markov model developed from a U.S. payer's perspective, we compared VMP with MPT and MPR-R over a lifetime horizon. MPT and MPR-R were chosen because, like VMP, they are superior to MP in response and outcomes. Data from the Velcade as Initial Standard Therapy in Multiple Myeloma (VISTA; VMP), Intergroupe Francophone du Myelome (IFM) 99\u201306 (MPT), and MM-015 (MPR-R) trials were used. The IFM 99\u201306 study was selected because of the superior activity in this study compared with other MPT studies. Using patient-level (VMP) and published (MPT, MPR-R) data, we estimated the health-state transition and adverse event probabilities for each regimen, related costs, and state-specific utility estimates. Costs (in 2010 U.S. dollars) and health outcomes were discounted at 3%.<\/jats:p>\n               <jats:p>Discounted lifetime direct medical costs were lowest with VMP at $119,102. MPT cost $142,452 whereas MPR-R cost $248,358. Incremental cost-effectiveness ratio calculations projected that VMP would confer cost savings and better health outcomes relative to MPT and MPR-R. We conclude that VMP is highly likely to be cost-effective compared with MP, MPT, and MPR-R.<\/jats:p>","DOI":"10.1634\/theoncologist.2011-0380","type":"journal-article","created":{"date-parts":[[2013,1,9]],"date-time":"2013-01-09T14:04:12Z","timestamp":1357740252000},"page":"27-36","source":"Crossref","is-referenced-by-count":42,"title":["The Cost-Effectiveness of Initial Treatment of Multiple Myeloma in the U.S. With Bortezomib Plus Melphalan and Prednisone Versus Thalidomide Plus Melphalan and Prednisone or Lenalidomide Plus Melphalan and Prednisone With Continuous Lenalidomide Maintenance Treatment"],"prefix":"10.1093","volume":"18","author":[{"suffix":"Jr.","given":"Louis P.","family":"Garrison","sequence":"first","affiliation":[{"name":"a University of Washington School of Pharmacy, Seattle, Washington, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Si-Tien","family":"Wang","sequence":"additional","affiliation":[{"name":"b Analysis Group, Inc., Boston, Massachusetts, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Huang","sequence":"additional","affiliation":[{"name":"c Millennium Pharmaceuticals, Inc., Cambridge, Massachusetts, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abbie","family":"Ba-Mancini","sequence":"additional","affiliation":[{"name":"c Millennium Pharmaceuticals, Inc., Cambridge, Massachusetts, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongliang","family":"Shi","sequence":"additional","affiliation":[{"name":"c Millennium Pharmaceuticals, Inc., Cambridge, Massachusetts, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Chen","sequence":"additional","affiliation":[{"name":"b Analysis Group, Inc., Boston, Massachusetts, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Korves","sequence":"additional","affiliation":[{"name":"b Analysis Group, Inc., Boston, Massachusetts, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravinder","family":"Dhawan","sequence":"additional","affiliation":[{"name":"d Janssen Research & Development, Raritan, New Jersey, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Cakana","sequence":"additional","affiliation":[{"name":"e Janssen Research & Development, High Wycombe, United Kingdom;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helgi","family":"van de Velde","sequence":"additional","affiliation":[{"name":"f Janssen Research & Development, Beerse, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deyanira","family":"Corzo","sequence":"additional","affiliation":[{"name":"c Millennium Pharmaceuticals, Inc., Cambridge, Massachusetts, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei Sheng","family":"Duh","sequence":"additional","affiliation":[{"name":"b Analysis Group, Inc., Boston, Massachusetts, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2013,1,8]]},"reference":[{"key":"2021122308344938300_B1","doi-asserted-by":"crossref","first-page":"2516","DOI":"10.1182\/blood-2007-10-116129","article-title":"Improved survival in multiple myeloma and the impact of novel therapies","volume":"111","author":"Kumar","year":"2008","journal-title":"Blood"},{"key":"2021122308344938300_B2","doi-asserted-by":"crossref","first-page":"947","DOI":"10.6004\/jnccn.2009.0062","article-title":"Novel therapies in the treatment of multiple myeloma","volume":"7","author":"Laubach","year":"2009","journal-title":"J Natl Compr Canc Netw"},{"key":"2021122308344938300_B3","first-page":"1","volume-title":"NCCN Clinical Practice Guidelines in Cancer. Multiple Myeloma, Version 1.2012","author":"National Comprehensive Cancer Network","year":"2012"},{"key":"2021122308344938300_B4","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.3109\/10428194.2010.487959","article-title":"Consensus statement from European experts on the diagnosis, management, and treatment of multiple myeloma: From standard therapy to novel approaches","volume":"51","author":"Engelhardt","year":"2010","journal-title":"Leuk Lymphoma"},{"key":"2021122308344938300_B5","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/j.1600-0609.2010.01524.x","article-title":"Addition of thalidomide to oral melphalan\/prednisone in patients with multiple myeloma not eligible for transplantation: Results of a randomized trial from the Turkish Myeloma Study Group","volume":"86","author":"Beksac","year":"2011","journal-title":"Eur J Haematol"},{"key":"2021122308344938300_B6","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1016\/S0140-6736(07)61537-2","article-title":"Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reduced-intensity autologous stem cell transplantation in elderly patients with multiple myeloma (IFM 99\u201306): A randomised trial","volume":"370","author":"Facon","year":"2007","journal-title":"Lancet"},{"key":"2021122308344938300_B7","doi-asserted-by":"crossref","first-page":"3664","DOI":"10.1200\/JCO.2008.21.0948","article-title":"Efficacy of melphalan and prednisone plus thalidomide in patients older than 75 years with newly diagnosed multiple myeloma: IFM 01\/01 trial","volume":"27","author":"Hulin","year":"2009","journal-title":"J Clin Oncol"},{"key":"2021122308344938300_B8","doi-asserted-by":"crossref","first-page":"2259","DOI":"10.1200\/JCO.2009.26.0638","article-title":"Bortezomib plus melphalan and prednisone compared with melphalan and prednisone in previously untreated multiple myeloma: Updated follow-up and impact of subsequent therapy in the phase III VISTA trial","volume":"28","author":"Mateos","year":"2010","journal-title":"J Clin Oncol"},{"key":"2021122308344938300_B9","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/S0140-6736(06)68338-4","article-title":"Oral melphalan and prednisone chemotherapy plus thalidomide compared with melphalan and prednisone alone in elderly patients with multiple myeloma: Randomised controlled trial","volume":"367","author":"Palumbo","year":"2006","journal-title":"Lancet"},{"key":"2021122308344938300_B10","doi-asserted-by":"crossref","first-page":"3107","DOI":"10.1182\/blood-2008-04-149427","article-title":"Oral melphalan, prednisone, and thalidomide in elderly patients with multiple myeloma: Updated results of a randomized, controlled 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