By: Sruthy Iype  Sep. 14, 2020

Dexur’s analysis of Medicare claims data showed that Velcade is used in three times as many multiple myeloma patients as compared to Kyprolis. The analysis was based on the J code usage of the drugs (J9041 /J9047) 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 cancer of plasma cells, a type of white blood cells formed within the bone marrow that produce antibodies. While the earlier stages of the disease tend to be asymptomatic, patients may experience symptoms like bone pain, bleeding, frequent infections, and anemia with the 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.

Velcade (bortezomib) and Kyprolis (carfilzomib), manufactured by Takeda Oncology and Amgen respectively, are proteasome inhibitors used as targeted therapies in the treatment of multiple myeloma. Proteasomes are enzyme complexes found in all cells that regulate the recycling of damaged and dysfunctional proteins, a process that is critical to the proper functioning of cells. Studies show that myeloma cells have an increased dependence on proteasomes for their survival and exhibit a higher sensitivity to their inhibition as compared to normal cells. These traits allow proteasome inhibitors to target MM cells and trigger programmed cell death in them.

Multiple myeloma patients who were administered with Velcade exceeded those administered with Kyprolis by a huge margin across all three years of the analysis. However, a continuous year by year decrease in the number of patients treated with Velcade, coupled with a steady growth in the number of patients treated with Kyprolis, has led to the progressive reduction in the difference between their market shares at a slow albeit steady rate during this period.

While the proportion of MM patients treated with Velcade was 3.6 times those who were treated with Kyprolis in 2017, the patient share for the former was 3.3 times that of the latter in 2018. The difference in usage further lessened in 2019, wherein the proportion of patients treated with the two drugs differed by a factor of 3. The study also showed that Velcade had an average of 10 claims per patient in a year while Kyprolis had about 13 claims on an average per patient.