Healthcare resource utilization and costs in patients with multiple myeloma administered ciltacabtagene autoleucel in outpatient versus inpatient settings after one to three prior lines of therapy

Background: Ciltacabtagene autoleucel (cilta-cel) was approved for patients with relapsed or refractory multiple myeloma who received 1–3 prior lines of therapy in April 2024. Although traditionally administered inpatient (IP), there is an increasing trend in outpatient (OP) cilta-cel administration. However, few studies have quantified the healthcare resource utilization (HCRU) and cost implications of OP versus IP administration in clinical practice. Aim: To compare HCRU and costs following OP versus IP administration of cilta-cel among patients with relapsed or refractory multiple myeloma after 1–3 prior lines of therapy. Materials & methods: This retrospective observational study used the Loopback Analytics electronic medical records database (28 February 2017 to 30 June 2025). We classified patients into OP or IP cohorts. All-cause and multiple myeloma-related HCRU and per-patient-per-month imputed costs were compared over 30 and 90 days post-infusion. Results: There were 99 patients included (OP: 37; IP: 62). In the first 30 days post-infusion, 40.5% of the OP cohort did not require IP admission. Compared with the IP cohort, the OP cohort had significantly lower all-cause IP days (adjusted incidence rate ratio: 0.31; p < 0.001) and significantly lower all-cause IP-related imputed costs (adjusted mean difference: -$39,786; p < 0.001). Results were consistent over the first 90 days post-infusion and for multiple myeloma related HCRU and costs. Overall, OP administration was associated with an estimated cost savings of approximately $40,000 and $53,000 per patient in the first 30 and 90 days post-infusion, respectively. Conclusion: OP administration of cilta-cel was associated with significantly lower IP resource utilization and imputed costs over the first 3 months post-infusion relative to IP administration, supporting the potential economic value and adoption of OP cilta-cel delivery.