Cost Effectiveness of Treatment Sequences in Advanced Renal Cell Carcinoma

Mason, Neil; Joshi, Vidhu; Adashek, Jacob J.; Kim, Young‐Chul; Shah, Savan S.; Schneider, Amy M.; Chadha, Juskaran; Jim, Heather; Byrne, Margaret M.; Gilbert, Scott M.; Manley, Brandon; Spiess, Philippe E.; Chahoud, Jad

doi:10.1016/j.euo.2023.01.011

Cited by 7 publications

(3 citation statements)

References 29 publications

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“…71 Another cost-effectiveness analysis by Mason et al investigated treatment cost by risk stratification. 72 For favorable-risk patients, the sequence of lenvatinib plus pembrolizumab followed by second-line cabozantinib and axitinib plus pembrolizumab followed by second-line cabozantinib were the most cost-effective treatments. For intermediate-risk and poor-risk patients, ipilimumab with nivolumab followed by second-line cabozantinib was the most cost-effective regimen.…”

Section: Managed Care Strategiesmentioning

confidence: 99%

“…For intermediate-risk and poor-risk patients, ipilimumab with nivolumab followed by second-line cabozantinib was the most cost-effective regimen. 72 The CheckMate -67T trial was a randomized, open-label trial comparing subcutaneous nivolumab vs IV nivolumab in patients with previously treated metastatic ccRCC. 73 The co-primary end points were time-averaged serum concentration over 28 days and trough serum concentration at steady state of subcutaneous nivolumab vs IV nivolumab; ORR was a key secondary end point.…”

Section: Managed Care Strategiesmentioning

confidence: 99%

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Why EOM Participation Was Extremely Low—and How to Fix It

2023

Am J Manag Care

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IN JUNE 2022, the Center for Medicare and Medicaid Innovation (CMMI) announced the application period for the Enhancing Oncology Model (EOM), 1 the successor value-based payment model for medical oncology that followed the conclusion of CMMI's Oncology Care Model (OCM). During the application period there was skepticism about the model among potential participants, but also overwhelming optimism and interest in fi guring out how to navigate several profound challenges in EOM design relative to OCM. 2,3 The high number of EOM applicants represented clear evidence of such interest. 4

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Section: Managed Care Strategiesmentioning

confidence: 99%

Section: Managed Care Strategiesmentioning

confidence: 99%

Why EOM Participation Was Extremely Low—and How to Fix It

2023

Am J Manag Care

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“…14 Although effective, these combination therapies can negatively affect patients' quality of life because of increased financial burden and a complex spectrum of drug-related adverse events (AEs) such as fatigue, hypertension, diarrhea, hepatotoxicity, and autoimmune reactions such as pneumonitis and colitis. [15][16][17][18] Consequently, there is an unmet need for health care systems worldwide to better inform and support patients receiving these novel treatment regimens. Improving health care decision making and managing AEs from combined ICI and tyrosine kinase inhibitor (ICI-TKI) therapies necessitate providing patients with comprehensive, personalized educational, and symptom management materials that are easily accessible.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of a Smartphone Application for Education and Symptom Management of Patients With Renal Cell Carcinoma on Combined Tyrosine Kinase and Immune Checkpoint Inhibitors

Roman Souza,

Turner,

Gullapalli

et al. 2024

JCO Clin Cancer Inform

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PURPOSE Patients with advanced renal cell carcinoma (RCC) face significant challenges, stemming both from the complexities of the disease itself and the adverse effects of treatments. This study evaluated the feasibility and acceptability of a mobile health (mHealth) application tailored for education and symptom management of patients with advanced RCC receiving combined immune checkpoint inhibitor and tyrosine kinase inhibitor (ICI-TKI) therapy. METHODS The primary end points were acceptability and feasibility. Acceptability was defined as the proportion of patients approached who consented to participate, setting a benchmark of at least 50% for this metric. Feasibility was gauged by the completion rate of the intervention among the participants; it required at least 50% of participants to fully complete the intervention and at least 70% to finish half of the administered questionnaires. The secondary end points included knowledge assessment and patient-reported outcomes (PROs). PROs were evaluated using validated instruments. To discern the changes between pre- and post-educational module quiz scores, we used the Wilcoxon signed-rank test. Time-course data of PROs were visualized using line plots and then compared using paired t-tests. RESULTS From November 2022 to July 2023, 20 of 22 (90%) patients approached for the study consented and enrolled. Of the enrolled patients, 60% completed all questionnaires and knowledge assessments at every time point and 75% completed at least half of the surveys and questionnaires. Significant pre/post differences were noted in two of six quizzes in the knowledge assessment. This study population did not experience a significant change in PRO scores after starting therapy. CONCLUSION The mHealth application designed for education and symptom management in patients with advanced RCC undergoing combination ICI-TKI has proven to be both acceptable and feasible, meeting previous research benchmarks.

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