{"id":"https://openalex.org/W7214749720","doi":"https://doi.org/10.1016/j.vhri.2026.102137","title":"Cost-Effectiveness Analysis of Carfilzomib vs Bortezomib in Relapsed/Refractory Multiple Myeloma in Iran","display_name":"Cost-Effectiveness Analysis of Carfilzomib vs Bortezomib in Relapsed/Refractory Multiple Myeloma in Iran","publication_year":2026,"publication_date":"2026-09-29","ids":{"openalex":"https://openalex.org/W7214749720","doi":"https://doi.org/10.1016/j.vhri.2026.102137","pmid":"https://pubmed.ncbi.nlm.nih.gov/42810195"},"language":"en","primary_location":{"id":"doi:10.1016/j.vhri.2026.102137","doi":"https://doi.org/10.1016/j.vhri.2026.102137","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.vhri.2026.102137","pdf_url":null,"source":{"id":"https://openalex.org/S2764833115","display_name":"Value in Health Regional Issues","issn_l":"2212-1099","issn":["2212-1099","2212-1102"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","medline","poland-40","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Value in Health Regional Issues","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1016/j.vhri.2026.102137","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5042283660","display_name":"Neshaut Mashreghi Mohammadi","orcid":"https://orcid.org/0000-0002-8978-343X","observed_orcids":["https://orcid.org/0000-0002-8978-343X"]},"institutions":[{"id":"https://openalex.org/I4403928282","display_name":"Pharmaceutical Management and Economics Research Center","ror":"https://ror.org/01w4ywr53","country_code":"IR","type":"facility","lineage":["https://openalex.org/I4403928282","https://openalex.org/I4403928403","https://openalex.org/I70640408"]},{"id":"https://openalex.org/I70640408","display_name":"Tehran University of Medical Sciences","ror":"https://ror.org/01c4pz451","country_code":"IR","type":"education","lineage":["https://openalex.org/I70640408"]}],"countries":["IR"],"is_corresponding":false,"raw_author_name":"Neshaut Mashreghi Mohammadi","raw_affiliation_strings":["Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Pharmaceutical Management and Economics Research Center (PMERC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Pharmaceutical Management and Economics Research Center (PMERC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran","institution_ids":["https://openalex.org/I4403928282","https://openalex.org/I70640408"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5069422002","display_name":"Behzad Fatemi","orcid":"https://orcid.org/0000-0001-7912-7546","observed_orcids":["https://orcid.org/0000-0001-7912-7546"]},"institutions":[{"id":"https://openalex.org/I4403928282","display_name":"Pharmaceutical Management and Economics Research Center","ror":"https://ror.org/01w4ywr53","country_code":"IR","type":"facility","lineage":["https://openalex.org/I4403928282","https://openalex.org/I4403928403","https://openalex.org/I70640408"]},{"id":"https://openalex.org/I70640408","display_name":"Tehran University of Medical Sciences","ror":"https://ror.org/01c4pz451","country_code":"IR","type":"education","lineage":["https://openalex.org/I70640408"]}],"countries":["IR"],"is_corresponding":false,"raw_author_name":"Behzad Fatemi","raw_affiliation_strings":["Pharmaceutical Management and Economics Research Center (PMERC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Pharmaceutical Management and Economics Research Center (PMERC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran","institution_ids":["https://openalex.org/I4403928282","https://openalex.org/I70640408"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5094011968","display_name":"Mohammad Mahdi Raeis Zadeh","orcid":"https://orcid.org/0000-0003-3577-9635","observed_orcids":["https://orcid.org/0000-0003-3577-9635"]},"institutions":[{"id":"https://openalex.org/I4403928282","display_name":"Pharmaceutical Management and Economics Research Center","ror":"https://ror.org/01w4ywr53","country_code":"IR","type":"facility","lineage":["https://openalex.org/I4403928282","https://openalex.org/I4403928403","https://openalex.org/I70640408"]},{"id":"https://openalex.org/I70640408","display_name":"Tehran University of Medical Sciences","ror":"https://ror.org/01c4pz451","country_code":"IR","type":"education","lineage":["https://openalex.org/I70640408"]}],"countries":["IR"],"is_corresponding":false,"raw_author_name":"Mohammad Mahdi Raeis Zadeh","raw_affiliation_strings":["Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Pharmaceutical Management and Economics Research Center (PMERC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Pharmaceutical Management and Economics Research Center (PMERC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran","institution_ids":["https://openalex.org/I4403928282","https://openalex.org/I70640408"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5025053518","display_name":"Shekoufeh Nikfar","orcid":"https://orcid.org/0000-0002-5206-6197","observed_orcids":["https://orcid.org/0000-0002-5206-6197"]},"institutions":[{"id":"https://openalex.org/I4403928282","display_name":"Pharmaceutical Management and Economics Research Center","ror":"https://ror.org/01w4ywr53","country_code":"IR","type":"facility","lineage":["https://openalex.org/I4403928282","https://openalex.org/I4403928403","https://openalex.org/I70640408"]},{"id":"https://openalex.org/I70640408","display_name":"Tehran University of Medical Sciences","ror":"https://ror.org/01c4pz451","country_code":"IR","type":"education","lineage":["https://openalex.org/I70640408"]}],"countries":["IR"],"is_corresponding":true,"raw_author_name":"Shekoufeh Nikfar","raw_affiliation_strings":["Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Pharmaceutical Management and Economics Research Center (PMERC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran. Electronic address: shekoufeh.nikfar@gmail.com"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Pharmaceutical Management and Economics Research Center (PMERC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran. Electronic address: shekoufeh.nikfar@gmail.com","institution_ids":["https://openalex.org/I4403928282","https://openalex.org/I70640408"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5025053518"],"corresponding_institution_ids":["https://openalex.org/I4403928282","https://openalex.org/I70640408"],"apc_list":{"value":2400,"currency":"USD","value_usd":2400},"apc_paid":{"value":2400,"currency":"USD","value_usd":2400},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"59","issue":null,"first_page":"102137","last_page":"102137"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10804","display_name":"Health Systems, Economic Evaluations, Quality of Life","score":0.8604000210762024,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10804","display_name":"Health Systems, Economic Evaluations, Quality of Life","score":0.8604000210762024,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10649","display_name":"Multiple Myeloma Research and Treatments","score":0.1307000070810318,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11221","display_name":"Bone health and treatments","score":0.0017000000225380063,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/carfilzomib","display_name":"carfilzomib","score":0.9670000076293945},{"id":"https://openalex.org/keywords/bortezomib","display_name":"bortezomib","score":1.0},{"id":"https://openalex.org/keywords/relapsed-refractory-multiple-myeloma","display_name":"relapsed/refractory multiple myeloma","score":0.9850000143051147},{"id":"https://openalex.org/keywords/cost-effectiveness","display_name":"cost-effectiveness","score":0.8349999785423279},{"id":"https://openalex.org/keywords/proteasome-inhibitors","display_name":"proteasome inhibitors","score":0.9929999709129333},{"id":"https://openalex.org/keywords/quality-adjusted-life-years","display_name":"quality-adjusted life years","score":0.9599999785423279},{"id":"https://openalex.org/keywords/incremental-cost-effectiveness-ratio","display_name":"incremental cost-effectiveness ratio","score":0.9269999861717224},{"id":"https://openalex.org/keywords/iran","display_name":"Iran","score":0.3889999985694885},{"id":"https://openalex.org/keywords/health-care-costs","display_name":"health care costs","score":0.5559999942779541}],"concepts":[{"id":"https://openalex.org/C2780108899","wikidata":"https://www.wikidata.org/wiki/Q15366934","display_name":"Carfilzomib","level":4,"score":0.9652000069618225},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8702999949455261},{"id":"https://openalex.org/C2776364478","wikidata":"https://www.wikidata.org/wiki/Q467635","display_name":"Multiple myeloma","level":2,"score":0.8475000262260437},{"id":"https://openalex.org/C2777478702","wikidata":"https://www.wikidata.org/wiki/Q419319","display_name":"Bortezomib","level":3,"score":0.8252000212669373},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.7093999981880188},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.6252999901771545},{"id":"https://openalex.org/C2778367456","wikidata":"https://www.wikidata.org/wiki/Q7251235","display_name":"Proteasome inhibitor","level":3,"score":0.36079999804496765},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.24809999763965607},{"id":"https://openalex.org/C3019894029","wikidata":"https://www.wikidata.org/wiki/Q332823","display_name":"Overall survival","level":2,"score":0.19920000433921814},{"id":"https://openalex.org/C188758523","wikidata":"https://www.wikidata.org/wiki/Q6947334","display_name":"Myeloma protein","level":3,"score":0.1923000067472458}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1016/j.vhri.2026.102137","doi":"https://doi.org/10.1016/j.vhri.2026.102137","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.vhri.2026.102137","pdf_url":null,"source":{"id":"https://openalex.org/S2764833115","display_name":"Value in Health Regional Issues","issn_l":"2212-1099","issn":["2212-1099","2212-1102"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","medline","poland-40","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Value in Health Regional Issues","raw_type":"journal-article"},{"id":"pmid:42810195","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42810195","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Value in health regional issues","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.1016/j.vhri.2026.102137","doi":"https://doi.org/10.1016/j.vhri.2026.102137","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.vhri.2026.102137","pdf_url":null,"source":{"id":"https://openalex.org/S2764833115","display_name":"Value in Health Regional Issues","issn_l":"2212-1099","issn":["2212-1099","2212-1102"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","medline","poland-40","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Value in Health Regional Issues","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.9763000011444092}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":19,"referenced_works":["https://openalex.org/W1571761716","https://openalex.org/W2017072183","https://openalex.org/W2087951656","https://openalex.org/W2157931999","https://openalex.org/W2193716145","https://openalex.org/W2340641313","https://openalex.org/W2749746182","https://openalex.org/W2761712406","https://openalex.org/W2909969046","https://openalex.org/W2969972205","https://openalex.org/W2970922094","https://openalex.org/W2996593023","https://openalex.org/W3038962705","https://openalex.org/W3108709596","https://openalex.org/W3158356424","https://openalex.org/W4280556871","https://openalex.org/W4405218942","https://openalex.org/W4406438518","https://openalex.org/W4406878529"],"related_works":["https://openalex.org/W6977562038","https://openalex.org/W2761712406","https://openalex.org/W10535914","https://openalex.org/W2777682015","https://openalex.org/W2759041666","https://openalex.org/W2020368872","https://openalex.org/W2346242965","https://openalex.org/W2948684401","https://openalex.org/W2982423776","https://openalex.org/W2903792162"],"abstract_inverted_index":{"OBJECTIVES:":[0],"Multiple":[1],"myeloma,":[2],"the":[3,59,103,201],"second":[4],"most":[5],"common":[6],"hematologic":[7],"malignancy,":[8],"primarily":[9],"affects":[10],"older":[11],"adults.":[12],"Proteasome":[13],"inhibitors":[14],"such":[15],"as":[16],"carfilzomib":[17,160],"and":[18,30,55,65,75,100,111,135],"bortezomib":[19,148],"are":[20,37],"key":[21],"treatment":[22,157,202],"options.":[23],"Because":[24],"of":[25,193,203],"high":[26],"costs,":[27,77],"disease":[28],"progression,":[29],"differences":[31],"in":[32,149,154,207],"drug":[33],"outcomes,":[34,227],"cost-effectiveness":[35,45,92,191,232],"evaluations":[36],"crucial":[38],"for":[39,159,168],"healthcare":[40],"policy.":[41],"METHODS:":[42],"A":[43,62],"model-based":[44],"study":[46],"was":[47,84,94,117,143,185],"conducted":[48],"using":[49,86],"Partitioned":[50],"Survival":[51],"Analysis":[52],"with":[53,165,175,219],"clinical":[54,212],"quality-of-life":[56],"data":[57],"from":[58],"ENDEAVOR":[60],"trial.":[61],"societal":[63],"perspective":[64],"20-year":[66],"time":[67],"horizon":[68],"were":[69,106,139],"applied,":[70],"encompassing":[71],"direct":[72],"medical,":[73],"nonmedical,":[74],"indirect":[76],"refined":[78],"through":[79],"expert":[80],"consultation.":[81],"Treatment":[82],"effectiveness":[83,213],"measured":[85],"quality-adjusted":[87],"life-years":[88],"(QALYs),":[89],"whereas":[90],"incremental":[91,183,190],"ratio":[93,192],"applied":[95],"to":[96,147],"determine":[97],"cost-effectiveness.":[98],"Costs":[99],"outcomes":[101],"beyond":[102],"first":[104],"year":[105],"discounted":[107],"annually":[108],"at":[109,119,234],"5.8%":[110],"5%,":[112],"respectively.":[113],"The":[114],"willingness-to-pay":[115],"threshold":[116],"set":[118],"$6065.57":[120],"(1":[121],"Iranian":[122],"gross":[123],"domestic":[124],"product/capita).":[125],"To":[126],"address":[127],"model":[128],"uncertainty,":[129],"tornado":[130],"diagrams,":[131],"1-way":[132],"sensitivity":[133],"analyses,":[134],"Monte":[136],"Carlo":[137],"simulations":[138],"performed.":[140],"RESULTS:":[141],"Carfilzomib":[142,170,209,228],"not":[144,230],"cost-effective":[145],"relative":[146],"treating":[150],"relapsed/refractory":[151,204],"multiple":[152,205],"myeloma":[153,206],"Iran.":[155],"Total":[156],"cost":[158,184],"reached":[161],"$100":[162],"139.98":[163],"compared":[164],"$31":[166],"100.49":[167],"bortezomib.":[169],"achieved":[171],"higher":[172,221],"health":[173,226],"gains,":[174],"3.43":[176],"QALYs":[177],"vs":[178],"2.94":[179],"QALYs.":[180],"However,":[181],"its":[182,224],"$69":[186],"039.49,":[187],"yielding":[188],"an":[189],"$139":[194],"206.61":[195],"per":[196],"QALY":[197],"gained.":[198],"CONCLUSION:":[199],"In":[200],"Iran,":[208],"demonstrates":[210],"greater":[211],"than":[214],"Bortezomib":[215],"but":[216],"is":[217],"associated":[218],"substantially":[220],"costs.":[222],"Despite":[223],"improved":[225],"does":[229],"meet":[231],"criteria":[233],"current":[235],"market":[236],"prices.":[237]},"counts_by_year":[],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2026-09-30T00:00:00"}