The total expense of the lenaldomde plus dexamethasone regmencludng expense of prophylaxs for DVT and pulmonary embolsm was US 72,822, whch represents a one.five foldhgher complete value compared wth ether thaldomde plus dexamethasone, or bortezomb plus doxorubcn.Ths studyhas quite a few weaknesses of whch probably the most mportanthat t does not account for dfferences effcacy as a functoof cost.No consderatowas gveto the patent populatons, whch the pvotal phase trals of lenaldomde nvolved aheavy pretreated popula towth relapsed or refractory dsease, wth a consequent mpact oduratoof treatment and adverse occasions.As oral drugs, lenaldomde and thaldomde combnatowth dexamethasone would be expected to present amprovement overall health related qualty of lfe compared wth combnatobortezomb plus doxorubcn, whch are admnstered as ntravenous nfusons.
however, ths review provides a startng pont for comparsons betweeMM therapes and s a vald method to economc analyss in the vewpont from the payer.Addtonalhealth economc studes of lenaldomde are requred that nclude qualty of buy INCB018424 lfe measures and information othe cost utty of treatment.a chart revew carried out fve unverstyhosptals France durng the perod 2004 2007, the total drect charges of typical care of patents wth relapsed or refractory selelck kinase inhibitor MM have been estmated at 73, 000 per patent from frst relapse unt death or last comply with up.134 The examine ncluded a complete of 102 patents wth a meaage at dagnoss of 59ears and a meaof 2.eight lnes of therapy snce frst relapse.Novel agents have been utilised 205 of 281 lnes and conssted of thaldomde combnatotherapy, bortezomb, lenaldomde, and bortezomb plus thaldomde.
The typical value per lne was 26, 510 ncludng 17,525 for medicines.Wth respect towards the thrd lne of treatment method, lenaldomde based mostly

therapy was smar to bortezomb meaduratoand value of treatment for lenaldomde was seven.four months and 46,724 compared wth 6.9 months and 46,321 for bortezomb.Denz and colleagues utilised a dscrete event smula tomodel to estmate the lengthy termhealth and cost consequences of lenaldomde plus dexamethasone versus dexamethasone alone MM patents who receved ether 1 or two pror therapes.135 The model employed patent responses to treatment method and tme to event information based oWebull functons derved from pooled information in the MM 009 and MM 010 clncal studes.Long term outcomes from Uk Medcal Study Counc sponsored trals and Mayo Clnc information have been utilized to calculate dexamethasone survval gvethat 47% of patents the dexamethasone arm in the MM 009 and MM 010 trals crossed above to receve lenaldomde treatment method followng dsease progres soor ethcal unblndng.Dsease management prices had been reflectve of clncal practce Wales, Uk.Cost andhealth outcomes were dscounted at three.5% per annum to alter to current values.