The Institute for Clinical and Economic Review (ICER) conducted a systematic literature review and cost effectiveness analysis to evaluate the health and economic outcomes of 3 new treatments targeting the B-cell maturation antigen (BCMA) for heavily pretreated patients with RRMM. BCMA is preferentially expressed on plasma cells, making it an attractive therapeutic target for MM. Belantamab mafodotin blmf (Blenrep, GlaxoSmithKline) is an antibody drug conjugate, with a monoclonal antibody to BCMA linked to a cytotoxic drug. Belantamab was studied in patients with heavily pretreated (6-7 previous lines of therapy) TCRMM (majority quad- and penta-refractory, usually defined as refractory to 4 or 5 agents across all 3 drug classes previously mentioned). Idecabtagene vicleucel (ide-cel, Abecma, Bristol Myers Squibb and bluebird bio) and ciltacabtagene autoleucel (cilta-cel, Janssen and Legend biotech) are chimeric antigen receptor (CAR) T-cell therapies, involving engineering a patient’s own T cells to target BCMA. Ide-cel and cilta-cel were studied in patients who were mostly TCRMM (majority triple- or quad-refractory patients). Belantamab was approved by the US Food and Drug Administration (FDA) for RRMM in August 2020; idecel was approved in March 2021; and cilta-cel was granted fast track designation and has a Prescription Drug User Fee Act (PDUFA) target action date of November 29, 2021. Complete details of ICER’s systematic literature search and protocol, as well as the methodology and model structure for the economic evaluation, are available on ICER’s website at https://icer.org/assessment/multiplemyeloma-2021/. In this review, we present the summary of our findings and highlights of the policy discussion with key stakeholders held at a public meeting of the Midwest Comparative Effectiveness Public Advisory Council on April 16, 2021. In addition, new data for cilta-cel has become available since that meeting and is highlighted here.
