Threshold Price of Belantamab for Relapsed/Refractory Multiple Myeloma in China: A Cost-Effectiveness Analysis

Multiple myeloma is a life-threatening hematologic malignancy with a rising incidence and significant economic burden, driven largely by costly novel therapies. This study estimated the value-based price of belantamab, a novel agent for relapsed or refractory multiple myeloma, from the perspective of the Chinese healthcare system.

A three-state partitioned survival model was constructed to compare belantamab plus bortezomib and dexamethasone (BVd) versus daratumumab plus bortezomib and dexamethasone (DVd) for the treatment of relapsed or refractory multiple myeloma over a lifetime horizon. Efficacy data were based on the DREAMM-7 trial (ClinicalTrials.gov identifier: NCT04246047). Cost inputs included the drug acquisition and administration, subsequent treatment, monitoring for post progression, disease evaluation and laboratory testing, and serious adverse events management. Health utilities were derived from published studies. Both costs and quality-adjusted life years (QALYs) were discounted at an annual rate of 4.5%. Probabilistic sensitivity analysis with 10,000 Monte Carlo simulations was conducted to estimate the threshold price of belantamab at a willingness-to-pay (WTP) threshold of twice China's 2025 GDP per capita (US$29,444 per QALY).

The BVd regimen yielded 6.15 QALYs compared with 4.51 QALYs for the DVd regimen. The probabilistic mean threshold price of belantamab was US$5.73/mg (95% CrI 2.16-8.89) at a WTP threshold of US$29,444/QALY.

The threshold price of belantamab for BVd to be cost effective over DVd is US$5.73/mg at a WTP threshold of twice China's GDP per capita, indicating a need for a very substantial price reduction of approximately 98% from the US list price. This estimate provides evidence-based reference for future national price negotiation and reimbursement decisions in China.