{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:03:21Z","timestamp":1791893001400,"version":"4.3.4"},"reference-count":45,"publisher":"Becaris Publishing Limited","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Comp. Eff. Res."],"abstract":"<jats:p>\n                    <jats:bold>Aim:<\/jats:bold>\n                    Expanding treatment options for transplant-ineligible newly diagnosed multiple myeloma (ndMM) in China has increased the need to identify treatment strategies that improve patient outcomes while using healthcare resources efficiently. This study evaluated the cost-effectiveness of in-class transition (iCT) to ixazomib, lenalidomide and dexamethasone (IRd) versus daratumumab, lenalidomide and dexamethasone (DRd) for transplant-ineligible ndMM from the perspective of the Chinese healthcare system.\n                    <jats:bold>Materials &amp; methods:<\/jats:bold>\n                    A cost-effectiveness analysis was conducted using a Markov cohort model that simulated lifetime health benefits and medical costs for the two treatment modalities. Model inputs were estimated from best available real-world evidence in the literature and from public data sources. Deterministic, probabilistic and scenario sensitivity analyses were performed to assess uncertainty in model results.\n                    <jats:bold>Results:<\/jats:bold>\n                    In the base-case analysis, iCT IRd was projected to generate 0.580 additional quality-adjusted life years versus DRd (4.724 vs 4.144) and save lifetime medical costs by $7751. One-way sensitivity analysis indicated that cost-effectiveness was driven by uncertainty in model inputs related to treatment discontinuation and subsequent disease progression. Probabilistic sensitivity analysis estimated that iCT IRd had 79.2%, 88.0% and 91.3% probabilities of being cost-effective at willingness-to-pay thresholds of one, two and three-times China\u2019s 2025 gross domestic product per capita per quality-adjusted life year, respectively.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Based on best available real-world evidence, the iCT IRd modality could be cost-effective compared with the DRd modality for transplant-ineligible patients with ndMM in China. Future real-world studies are needed to confirm the projected outcomes.\n                  <\/jats:p>","DOI":"10.57264\/cer-2026-0146","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:31:48Z","timestamp":1791891108000},"source":"Crossref","is-referenced-by-count":0,"title":["Real-world cost-effectiveness of sequential therapy of in-class transition to ixazomib versus daratumumab for transplant-ineligible newly diagnosed multiple myeloma in China"],"prefix":"10.57264","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9305-9671","authenticated-orcid":false,"given":"Genyong","family":"Zuo","sequence":"first","affiliation":[{"name":"Centre for Health Management &amp; Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China"},{"name":"NHC Key Lab of Health Economics &amp; Policy Research, Shandong University, Jinan, Shandong, 250012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aijun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hematology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, 100020, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zunmin","family":"Zhu","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, Zhengzhou University, Zhengzhou, Henan, 450000, China"},{"name":"Department of Hematology, Henan Provincial People's Hospital, Zhengzhou, Henan, 450000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Hematology, Beijing Jishuitan Hospital, Beijing, 100096, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050011, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongbo","family":"Gao","sequence":"additional","affiliation":[{"name":"Medical Affairs, Takeda (China) International Trading Company, Beijing, 100027, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9517-4745","authenticated-orcid":false,"given":"Wendong","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute of Hospital Management Research, Xiangya Hospital of Central South University, Changsha, Hunan, 410008, China"},{"name":"Toronto Health Economics &amp; Technology Assessment Collaborative, University of Toronto, Toronto, Ontario, M5G 2C4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9928-9224","authenticated-orcid":false,"given":"Rong","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tianjin Medical University General Hospital, Tianjin, 300052, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3582-2102","authenticated-orcid":false,"given":"Wenming","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Hematology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, 100020, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"36897","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_3_10_3_2","doi-asserted-by":"crossref","first-page":"217440","DOI":"10.1016\/j.canlet.2025.217440","article-title":"The burden of multiple myeloma in China: trends from 1990 to 2021 and forecasts for 2050","volume":"611","author":"Dou X","year":"2025","unstructured":"Dou X, Duan G, Zhong Y The burden of multiple myeloma in China: trends from 1990 to 2021 and forecasts for 2050. Cancer Lett. 611, 217440 (2025).","journal-title":"Cancer Lett."},{"issue":"5","key":"e_1_3_10_4_2","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.3390\/cancers15051558","article-title":"Novel agents as main drivers for continued improvement in survival in multiple myeloma","volume":"15","author":"Puertas B","year":"2023","unstructured":"Puertas B, Gonzalez-Calle V, Sobejano-Fuertes E Novel agents as main drivers for continued improvement in survival in multiple myeloma. Cancers (Basel) 15(5), 1558 (2023).","journal-title":"Cancers (Basel)"},{"issue":"1","key":"e_1_3_10_5_2","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1038\/s41408-025-01311-y","article-title":"Attrition rates and treatment outcomes in multiple myeloma: real-world data over a 40-year period","volume":"15","author":"Rodriguez-Lobato LG","year":"2025","unstructured":"Rodriguez-Lobato LG, de Daniel A, Pereira A Attrition rates and treatment outcomes in multiple myeloma: real-world data over a 40-year period. Blood Cancer J. 15(1), 103 (2025).","journal-title":"Blood Cancer J."},{"issue":"5","key":"e_1_3_10_6_2","first-page":"247","article-title":"Novel approaches to the treatment of multiple myeloma","volume":"21","author":"Maples KT","year":"2023","unstructured":"Maples KT, Scott SA, Lonial S. Novel approaches to the treatment of multiple myeloma. Clin. Adv. Hematol. Oncol. 21(5), 247\u2013256 (2023).","journal-title":"Clin. Adv. Hematol. Oncol."},{"issue":"12","key":"e_1_3_10_7_2","first-page":"1186","article-title":"Guidelines for the diagnosis and management of multiple myeloma in China (2024 revision)","volume":"63","author":"Branch CMDAHP, Branch CMAH","year":"2024","unstructured":"Branch CMDAHP, Branch CMAH. Guidelines for the diagnosis and management of multiple myeloma in China (2024 revision). Zhonghua Nei Ke Za Zhi 63(12), 1186\u20131195 (2024).","journal-title":"Zhonghua Nei Ke Za Zhi"},{"issue":"11","key":"e_1_3_10_8_2","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1016\/S1470-2045(21)00466-6","article-title":"Daratumumab, lenalidomide, and dexamethasone versus lenalidomide and dexamethasone alone in newly diagnosed multiple myeloma (MAIA): overall survival results from a randomised, open-label, Phase III trial","volume":"22","author":"Facon T","year":"2021","unstructured":"Facon T, Kumar SK, Plesner T Daratumumab, lenalidomide, and dexamethasone versus lenalidomide and dexamethasone alone in newly diagnosed multiple myeloma (MAIA): overall survival results from a randomised, open-label, Phase III trial. 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Blood 138(Suppl. 1), 1979 (2021).","journal-title":"Blood"},{"issue":"2","key":"e_1_3_10_10_2","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/s11899-018-0443-0","article-title":"Common adverse effects of novel therapies for multiple myeloma (MM) and their management strategies","volume":"13","author":"McCullough KB","year":"2018","unstructured":"McCullough KB, Hobbs MA, Abeykoon JP, Kapoor P. Common adverse effects of novel therapies for multiple myeloma (MM) and their management strategies. Curr. Hematol. Malig. Rep. 13(2), 114\u2013124 (2018).","journal-title":"Curr. Hematol. Malig. 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Cancer Med. 13(9), e7177 (2024).","journal-title":"Cancer Med."},{"issue":"26","key":"e_1_3_10_15_2","doi-asserted-by":"crossref","first-page":"3616","DOI":"10.1182\/blood.2020008787","article-title":"Oral ixazomib, lenalidomide, and dexamethasone for transplant-ineligible patients with newly diagnosed multiple myeloma","volume":"137","author":"Facon T","year":"2021","unstructured":"Facon T, Venner CP, Bahlis NJ Oral ixazomib, lenalidomide, and dexamethasone for transplant-ineligible patients with newly diagnosed multiple myeloma. 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Lymphoma"},{"issue":"1","key":"e_1_3_10_29_2","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1038\/s41408-023-00912-9","article-title":"In-class transition (iCT) of proteasome inhibitor-based therapy: a community approach to multiple myeloma management","volume":"13","author":"Rifkin RM","year":"2023","unstructured":"Rifkin RM, Girnius SK, Noga SJ In-class transition (iCT) of proteasome inhibitor-based therapy: a community approach to multiple myeloma management. 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Lymphoma Myeloma Leuk."},{"key":"e_1_3_10_31_2","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1182\/blood-2023-187233","article-title":"Comparison of time to next treatment or death between front-line daratumumab, lenalidomide, and dexamethasone (DRd) and bortezomib, lenalidomide, and dexamethasone (VRd) in transplant ineligible patients with multiple myeloma","volume":"142","author":"Hansen DK","year":"2023","unstructured":"Hansen DK, Gautam S, Lafeuille MH Comparison of time to next treatment or death between front-line daratumumab, lenalidomide, and dexamethasone (DRd) and bortezomib, lenalidomide, and dexamethasone (VRd) in transplant ineligible patients with multiple myeloma. Blood 142, 543 (2023).","journal-title":"Blood"},{"issue":"9","key":"e_1_3_10_32_2","doi-asserted-by":"crossref","first-page":"e7232","DOI":"10.1002\/cam4.7232","article-title":"Clinical outcomes of pomalidomide-based and daratumumab-based therapies in patients with relapsed\/refractory multiple myeloma: a real-world cohort study in China","volume":"13","author":"Han X","year":"2024","unstructured":"Han X, Jiang X, He J Clinical outcomes of pomalidomide-based and daratumumab-based therapies in patients with relapsed\/refractory multiple myeloma: a real-world cohort study in China. 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