Cost-effectiveness analysis of additional bevacizumab to pemetrexed plus cisplatin for malignant pleural mesothelioma based on the MAPS trial

Malignant mesothelioma is a rare and devastating form of cancer with an increasing economic burden. We sought to describe the direct cost burden of mesothelioma to the US health system. A systematic literature review was performed to locate published estimates of the medical cost of mesothelioma. In addition, we performed an analysis of hospital discharge data from the National Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. We also reviewed publicly available legal settlements. We found that published estimates of the cost of medical care for mesothelioma are sparse, and differ with respect to nation, timeframe, and types of cost included. For the year 2014 in the United States, we estimated a mean cost per mesothelioma hospitalization of US$24,124 (95% confidence interval: US$20,819–US$28,983) and a total cost for hospital care of US$44,214,835. In conclusion, we found that reports describing the direct medical cost of care for mesothelioma in the United States are lacking, yet the per-patient cost of care is substantial, as evidenced by analyses of inpatient care and legal settlements.

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“…One analysis determined that the routine addition of bevacizumab was not a cost-effective alternative in China. 30…”

Section: Discussionmentioning

confidence: 99%

Costs of medical care for mesothelioma

2019

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“…The ICERs associated with novel anticancer drugs may be unacceptably high in China. [20][21][22] Given that there are no other effective drugs for the maintenance treatment of pancreatic cancer and the proportion of pancreatic cancer patients with BRCA mutations is very low, PFS improvement derived from maintenance olaparib can be viewed as a major therapeutic advance. Some measures should be taken to improve the cost-effectiveness of these novel anticancer drugs.…”

Section: Discussionmentioning

confidence: 99%

<p>Cost-Effectiveness Analysis of Maintenance Olaparib in Patients with Metastatic Pancreatic Cancer and a Germline BRCA1/2 Mutation Based on the POLO Trial</p>

Zhan¹,

Zheng²,

Yu³

et al. 2020

CMAR

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Objective The phase III POLO trial demonstrated that olaparib as maintenance therapy for metastatic pancreatic cancer patients with a germline BRCA mutation had greater efficacy than placebo, but maintenance olaparib places an economic burden on patients. This study evaluated the cost-effectiveness of olaparib as maintenance therapy based on the POLO trial (NCT02184195). Methods A three-state Markov model (progression-free survival [PFS], progressive disease [PD] and death) based on data from the POLO trial was used to estimate the incremental cost-effectiveness ratio (ICER) of maintenance olaparib versus placebo for metastatic pancreatic cancer patients with a germline BRCA mutation. The cost was evaluated from the Chinese society’s perspective, and health outcomes were assessed in terms of quality-adjusted life years (QALYs). The primary outcome was the ICER gained in terms of 2019 US$ per QALY. Model robustness was explored with one-way and probabilistic sensitivity analyses. Results Compared with placebo, maintenance olaparib increased costs by $23,544.35 while gaining 0.69 QALYs, resulting in an ICER of $34,122.25 per QALY. The ICER was far higher than the commonly accepted willingness-to-pay threshold ($28,255.55 per QALY). Conclusion Compared with placebo, maintenance olaparib for metastatic pancreatic cancer patients with a germline BRCA mutation is not cost-effective in China.

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“…Esta revisão demonstrou que o tempo de permanência em diferentes fases no modelo de Markov, podem influenciar nos gastos, como por exemplo o aumento da permanência no estado de doença progressiva, como apontado por diversos autores Hirschmann A, et al (2018), em contraponto ao prolongamento do estado livre de progressão da doença (ZHAN M, et al 2017;CHEN HD, et al, 2017). Este resultado está relacionado a gravidade dos pacientes, ao uso das terapias em doses maiores, comorbidades e reações adversas mais incidentes, na fase em que a doença está em progresso (HIRSCHMANN A, et al, 2018).…”

Section: Discussionunclassified

Avaliação de Custo-efetividade nas terapias oncológicas, emprego de modelos de Markov: Uma revisão integrativa da literatura

Silva

2019

Acervo Saúde

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Objetivo: Revisar a literatura científica que aborda a relação custo-efetividade das terapias oncológicas, correlacionado com o limitar de disposição de pagar e qualidade de vida (QALYs). Métodos: Foi realizada uma revisão da literatura através da busca de publicações nos bancos de dados PUBMED, LILACS e EMBASE, em outubro de 2018. A estratégia de pesquisa consistiu em: termos para "cost effectiveness"; para "chemotherapy"; para “cancer”; e, associados ao termo “markov model”. Resultados: A pesquisa resultou em 209 publicações, dos quais ao final, 18 artigos compuseram essa revisão. Na maioria dos trabalhos, o modelo de Markov foi focado no estadiamento da doença, dividindo em três ciclos, Estado livre de progressão (PFS), Doença progressiva (DP) e Morte. Nas avaliações de custo-efetividade poucas terapias apresentaram melhorias no QALYS e um custo, sendo que as comparações que obtiveram, forma de terapias em que as drogas padrão já apresentavam um custo elevado, diminuindo o ICER da terapia inovadora. Conclusão: Os resultados da revisão apontaram uma notável dificuldade de justificar a inserção de novas terapias através dos estudos de custo-efetividade, assim como uma grande diferença entre o limite de disposição a pagar dos diferentes países, o que influencia diretamente na possibilidade de aquisição de novos tratamentos.

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Cost-effectiveness analysis of additional bevacizumab to pemetrexed plus cisplatin for malignant pleural mesothelioma based on the MAPS trial

Cited by 16 publications

References 23 publications

Costs of medical care for mesothelioma

Costs of medical care for mesothelioma

<p>Cost-Effectiveness Analysis of Maintenance Olaparib in Patients with Metastatic Pancreatic Cancer and a Germline BRCA1/2 Mutation Based on the POLO Trial</p>

Avaliação de Custo-efetividade nas terapias oncológicas, emprego de modelos de Markov: Uma revisão integrativa da literatura

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