Pharmacotherapy of multiple myeloma: an economic perspective

Since new treatments have recently been proposed for patients with multiple myeloma, the aim of this article is to review the main innovations in this therapeutic area and to examine the cost-effectiveness ratio. Innovative approaches include autologous transplantation and thalidomide, which are both utilised as induction or salvage treatments. According to a randomised trial conducted in 1996, the survival after autologous transplantation seems to be better than that following standard therapy; however, this result has not been confirmed by a recent study. Thalidomide has been found to be effective for relapsed or refractory myeloma and, more recently, also as induction therapy. Preliminary cost-effectiveness assessments about autologous transplantation and thalidomide have given promising results; yet one regulatory problem with thalidomide is that, both in Europe and in the US, the drug has not yet been approved for this indication.