Elranatamab (Elrexfio)

Key Messages

• CADTH recommends that Elrexfio should be reimbursed by public drug plans for the treatment of adult patients with relapsed or refractory multiple myeloma (MM) who have received at least 3 prior lines of therapy including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody, and who have demonstrated disease progression on the last therapy if certain conditions are met.
• Elrexfio should only be covered to treat patients aged 18 years and older with relapsed or refractory MM who have received at least 3 prior treatments, have disease that has not responded to their last treatment, have not received prior B-cell maturation antigen (BCMA)–targeted treatment, and are in relatively good health. Elrexfio should not be reimbursed for the treatment of those patients whose MM is affecting their brain or spinal cord or those showing signs that the tissue layers protecting the brain and spinal cord are affected by MM. It also should not be reimbursed for the treatment of those with amyloidosis (a buildup of a protein, amyloid, in organs) that is not secondary to MM, those with POEMS (polyneuropathy, organomegaly, endocrinopathy, myeloma protein, and skin changes) syndrome, and those with plasma cell leukemia.
• Elrexfio should only be reimbursed if it is prescribed and administered by health professionals at treatment centres with adequate medical resources and personnel, and if the price of Elrexfio is reduced.