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. 2025 Dec;28(1):910-920.
doi: 10.1080/13696998.2025.2514909. Epub 2025 Jun 14.

Cost per responder for teclistamab and elranatamab in relapsed or refractory multiple myeloma in the United States

Lucio N Gordan  1 , Arielle G Bensimon  2 , Fan Mu  2 , Nina Kim  3 , Bingcao Wu  3 , Dee Lin  3 , Agne Paner  3 , Jessica Fowler  3 , Alex Marshall  4 , Suzy Van Sanden  5 , Eric Ammann  4 , Joe Goble  3 , Xinke Zhang  3 , Hoa H Le  3 , Elissa E Min  3   6 , Louis P Garrison Jr  7
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Free article

Cost per responder for teclistamab and elranatamab in relapsed or refractory multiple myeloma in the United States

Lucio N Gordan et al. J Med Econ. 2025 Dec.
Free article

Abstract

Aims: Teclistamab and elranatamab are bispecific antibodies recently approved for the treatment of triple class-exposed relapsed/refractory multiple myeloma (RRMM). This study assessed the relative efficacy and economic value of teclistamab and elranatamab through a matching-adjusted indirect comparison (MAIC) and cost per responder analysis using data from the MajesTEC-1 (NCT03145181/NCT04557098) and MagnetisMM-3 (NCT04649359) trials.

Materials and methods: The MAIC compared overall response rate (ORR) between the therapies after weighting individual patient data from MajesTEC-1 to match key baseline characteristics in MagnetisMM-3. Matched covariates included age, refractory status, prior lines of therapy, extramedullary disease, performance status, disease stage, and cytogenetic risk profile. Cost per responder was calculated based on estimated per-patient drug acquisition and administration cost (2024 United States dollars) over 6 months divided by ORR. One-way and probabilistic sensitivity analyses were conducted to characterize uncertainty.

Results: The ORRs were 63.0% for teclistamab before matching (N = 165), 61.4% for teclistamab after matching (effective sample size = 92), and 61.0% for elranatamab (N = 123) (odds ratio after matching: 1.02; 95% confidence interval [CI]: 0.59, 1.77). Per-patient costs were estimated to be $231,435 for teclistamab and $285,201 for elranatamab (difference: -$53,766; 95% confidence interval [CI]: -$59,094, -$48,311), yielding costs per responder of $376,930 and $467,730, respectively (difference: --$90,800; 95% CI: -$183,680, $8,148).

Limitations: Because MajesTEC-1 and MagnetisMM-3 are single-arm trials, the MAIC was unanchored and therefore susceptible to confounding from any unadjusted effect modifiers or prognostic variables.

Conclusions: Teclistamab was associated with significantly lower treatment costs and numerically lower cost per responder than elranatamab in triple class-exposed RRMM.

Keywords: C67; I10; I19; Multiple myeloma; cost per responder; elranatamab; matching-adjusted indirect comparison; response rate; teclistamab.

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