Kyprolis and Velcade have 14 to 16 claims per patient per year for Multiple Myeloma compared to Darzalex and Empliciti which have 9 claims



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By: Sruthy Iype  Aug. 20, 2020

Dexur’s analysis of Medicare claims data showed that on an average, Kyprolis and Velcade have 14 to 16 claims per patient per year for Multiple Myeloma (MM) compared to Darzalex and Empliciti which have 9 claims per patient. The analysis was based on a sample of Medicare patients between Jan 2019 and Dec 2019, and looked at the J code usage of the drugs for the condition.The number of claims per patient data is a proxy for the number of injections / IV infusions / doses required by a patient. The study also tries to contrast the usage of these medications across three diagnosis categories- MM patients who have not achieved remission (C9000), MM patients in remission (C9001), and MM patients in relapse (C9002).

Multiple myeloma 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 and relieving the symptoms.

The drugs considered under this study are targeted therapies approved for the treatment of adult patients with multiple myeloma, alone or in combination with other medication. Unlike chemotherapy, these drugs specifically target the cancer cells and the mechanisms that support their growth, promising better results and fewer adverse effects. Kyprolis (carfilzomib) and Velcade (bortezomib) are proteasome inhibitors that can trigger apoptosis in cancer cells by blocking the action of proteasome, an enzyme complex that is critical in the regulation of cell-cycle. Darzalex (daratumumab) and Empliciti (elotuzumab) are monoclonal antibodies that enable the immune system to identify and kill cancer cells by targeting specific proteins on the cell surface.

HCPCS code HCPCS code description Drug Name
J9047 Injection, carfilzomib, 1 mg Kyprolis
J9041 Injection, bortezomib (velcade), 0.1 mg Velcade
J9145 Injection, daratumumab, 10 mg Darzalex
J9176 Injection, elotuzumab, 1mg Empliciti

The average usage of drug per patient was seen to be highest among MM patients who had not achieved remission, and least among MM patients in remission. An exception to this trend was Kyprolis, which had similar usage among patients in remission and patients in relapse, with the former having a marginally higher number of claims per patient.

Amgen’s Kyprolis had an average of 15.9 claims per patient in a year. The proteasome inhibitor indicated for the treatment of patients with relapsed/refractory MM, is used as a monotherapy, or as a combination therapy along with dexamethasone, or lenalidomide and dexamethasone.

Velcade, manufactured by Millennium Pharmaceuticals/Takeda Oncology in the U.S, had an average of 13.8 claims per patient in a year. It was noted to have the largest share of claims among the drugs, across the three diagnosis categories for multiple myeloma. Approved for the treatment of newly diagnosed and relapsed/refractory myeloma, the drug is used alone or as a part of combination therapies.

Darzalex, a CD38-directed cytolytic antibody by Janssen Biotech, had an average of 9.9 claims per patient in a year for MM. It is indicated for the treatment of MM as a monotherapy or in combination with other drugs including lenalidomide, dexamethasone, and bortezomib.

Bristol-Myers Squibb’s Empliciti had an average of 9.3 claims per patient. It is a SLAMF7-directed immunostimulatory antibody approved for the treatment of MM in combination with lenalidomide and dexamethasone, or pomalidomide and dexamethasone