By: Sruthy Iype  Sep. 11, 2020

Dexur’s analysis of Medicare claims data showed that Darzalex is used in six times as many multiple myeloma patients compared to Empliciti. The analysis looked at the J code usage of the drugs (J9145/J9176) among Medicare patients who received treatment in hospital outpatient settings between Jan 2017 and Dec 2019. The analysis also looks at the average claims per patient data, which is a proxy for the number of injections / IV infusions / doses administered to a patient.

Multiple myeloma (MM) is a form of blood cancer that involves the neoplastic proliferation of plasma cells, a type of white blood cells formed within the bone marrow. While the earlier stages of the disease tend to be asymptomatic, patients may experience symptoms like bone pain, bleeding, frequent infections, and anemia with progression of the cancer. Although there is no cure for MM, a number of treatment options including chemotherapy, stem cell transplantation, radiation therapy, and targeted therapy, can help in managing the progression of the disease.

Darzalex (daratumumab) and Empliciti (elotuzumab), manufactured by Janssen Biotech and Bristol-Myers Squibb respectively, are targeted therapies used in the treatment of adult patients with multiple myeloma. While both drugs have been approved for the treatment of relapsed/ refractory patients, Darzalex holds FDA-approval for use in newly diagnosed patients also. The monoclonal antibodies enable the immune system to identify and kill cancer cells by targeting specific proteins on the cell surface. Darzalex targets CD38, a surface protein that is overexpressed on multiple myeloma cells, and induces several mechanisms that result in the depletion of MM cells. Similarly, Empliciti exhibits anti-myeloma activity through multiple mechanisms by targeting SLAMF7 (Signaling Lymphocytic Activation Molecule F7), another cell surface protein highly expressed on MM cells.

Multiple myeloma patients who were administered Darzalex exceeded those administered Empliciti by a huge margin across all three years of the analysis. In 2017, the proportion of MM patients treated with Darzalex was 5.5 times those who were treated with Empliciti. The difference in market share of the two drugs further widened in 2018 when MM patients administered Darzalex were noted to be 6.7 times that of Empliciti. In 2019, a slight decrease was observed in the margin between the two drugs, wherein the share of MM patients for the former was 6.3 times that of the latter. Both drugs recorded similar average usage per patient of about 8 claims per year.