Budget impact analysis of daratumumab for light-chain amyloidosis in Cyprus

ObjectiveThe aim of this study is to assess the budget impact of daratumumab for light-chain amyloidosis in CyprusMethodsA budget impact model assessed the cost prior and after the introduction of daratumumab for light-chain amyloidosis. All related costs were set from the perspective of Cyprus NHS. Clinical data were extracted from the published trials. One-way sensitivity analysis was conducted. We reported incremental budget impact, per member per month, per year, and per treated member per monthResultsThe introduction of D-VCd led to a net budget impact of euro254,264 in the first year, which escalated to euro497,007 by fifth year. The PMPY was estimated at euro0.2893 in the first year, reaching euro0.5246 at fifth year, the PMPM were at euro0.0241 at the first year escalating to euro0.0437 at the fifth year, and the PTMPM costs were euro2,379 at the first year and gauged to euro4,435 by fifth year. Our results were sensitive to incidence of the disease, percentage of patients without cardiac involvement and daratumumab cost.ConclusionsThe introduction of daratumumab for AL amyloidosis, with a 90% annual uptake over 5 years, leads to a substantial budget impact. Managed entry agreement schemes can be considered in order to mitigate the impact.