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Research Article
29 June 2026

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

Authors: Murali Janakiram https://orcid.org/0000-0001-9323-8007, Sabyasachi Ghosh, Victoria Alegria, Matthew Perciavalle https://orcid.org/0000-0003-4572-9906, Bruno Emond https://orcid.org/0000-0002-0060-765X, Jessica Maitland https://orcid.org/0009-0002-6804-319X, Todd Bixby https://orcid.org/0009-0008-2031-3035, Saurabh P Nagar, Zaina P Qureshi https://orcid.org/0000-0001-9605-3980 [email protected], Dimitra Rafailia Bakaloudi, and Danai Dima https://orcid.org/0000-0002-3587-7975Author Info & Affiliations
Volume 15, Number 7
https://doi.org/10.57264/cer-2026-0052
PDFFormats

Abstract

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.

Plain language summary

What is this article about?

Ciltacabtagene autoleucel (cilta-cel) is a therapy for patients with multiple myeloma (MM) after previous treatment stops working. It can be given in a single-day outpatient (OP) setting or an inpatient (IP) setting, requiring hospitalization. We explored if administering cilta-cel in the OP versus IP setting reduces healthcare resource use and costs.

What methodology was used in this study?

This was an observational study using electronic medical records (EMR) data from US hospitals. Adults with MM who received cilta-cel after 1–3 prior lines of therapy were identified and classified into OP or IP administration groups. Healthcare resource use and associated costs were compared during the first 3 months following treatment between groups. Since the EMR data do not capture cost information, costs associated with healthcare resource use were imputed using published cost inputs on patients with MM.

What were the results?

We identified 99 patients treated with cilta-cel, with 37 in the OP setting and 62 in the IP setting. OP-treated patients experienced fewer hospitalized days per month compared with IP-treated patients. OP administration was associated with lower monthly total imputed costs driven primarily by reduced hospital days. Overall, OP cilta-cel administration led to an estimated cost savings over IP administration of approximately $40,000 and $53,000 per patient in the first 30 and 90 days following treatment.

Why are these results important?

These findings support the potential economic value of OP administration and highlight that its adoption may improve feasibility of and expand access to treatment.

Shareable abstract

Outpatient cilta-cel administration in multiple myeloma reduced HRU and led to $40K in cost savings per patient in the first month post-infusion compared with inpatient administration. Findings support expanding outpatient CAR-T models for high-value care. #multiplemyeloma #CART

Supplementary Material

File (supplemtary data.docx)

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