Economic Burden of Dermatologic Adverse Events Induced by Molecularly Targeted Cancer Agents

Borovicka, Judy H.

doi:10.1001/archdermatol.2011.719

Cited by 42 publications

(20 citation statements)

References 34 publications

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“…The costs of skin ADEs related to antineoplastic agents were estimated from €1,592.89 to €15,037.97 36,37. A study evaluated the costs of nonserious and serious skin ADEs according to spontaneous reports; the incremental total cost per patient was estimated as €373.33 and €3,383.56, respectively 38.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of observational studies evaluating costs of adverse drug reactions

Marques¹,

Penedones²,

Mendes³

et al. 2016

CEOR

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IntroductionThe growing evidence of the increased frequency and severity of adverse drug events (ADEs), besides the negative impact on patient’s health status, indicates that costs due to ADEs may be steadily rising. Observational studies are an important tool in pharmacovigilance. Despite these studies being more susceptible to bias than experimental designs, they are more competent in assessing ADEs and their associated costs.ObjectiveTo identify and characterize the best available evidence on ADE-associated costs.MethodsMEDLINE, Cochrane Library, and Embase were searched from 1995 to 2015. Observational studies were included. The methodological quality of selected studies was assessed by Cochrane Collaboration tool for experimental and observational studies. Studies were classified according to the setting analyzed in “ambulatory”, “hospital”, or both. Costs were classified as “direct” and “indirect”. Data were analyzed using descriptive statistics. The total incremental cost per patient with ADE was estimated.ResultsTwenty-nine (94%) longitudinal observational studies and two (7%) cross-sectional studies were included. Twenty-three (74%) studies were assessed with the highest methodological quality score. The studies were mainly conducted in the US (61%). Twenty (65%) studies evaluated any therapeutic group. Twenty (65%) studies estimated costs of ADEs leading to or prolonging hospitalization. The “direct costs” were evaluated in all studies, whereas only two (7%) also estimated the “indirect costs”. The “direct costs” in ambulatory ranged from €702.21 to €40,273.08, and the in hospital from €943.40 to €7,192.36.DiscussionMethodological heterogeneities were identified among the included studies, such as design, type of ADEs, suspected drugs, and type and structure of costs. Despite such discrepancies, the financial burden associated with ADE costs was found to be high. In the light of the present findings, validated methods to measure ADE-associated costs need future research efforts.

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Section: Resultsmentioning

confidence: 99%

A systematic review of observational studies evaluating costs of adverse drug reactions

Marques¹,

Penedones²,

Mendes³

et al. 2016

CEOR

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“…Immunogenic effects of anti-EGFR mAbs interfering with ADCC in bacterial defense could be considered beyond the well-known antiproliferative effects of EGFR inhibitors on non-mutated tissue. Moreover, the patient's burden as well as the economic burden even of non-life-threatening side effects may be considerable [6,19]. …”

Section: Discussionmentioning

confidence: 99%

Severe Pain Due to Paraspinal Abscess Formation in Two Patients with Squamous-Cell Carcinoma of the Head and Neck after Multimodal Treatment Including Cetuximab

et al. 2018

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Background: Patients with squamous-cell carcinoma of the head and neck (SCCHN) on palliative therapy usually have a bad prognosis and suffer from various symptoms. With increasing use of targeted agents in cancer patients at the end of life, the correct assignment of therapy-related symptoms becomes increasingly difficult as cancer-related symptoms usually increase as well. Case Report: We report on 2 cases of patients with SCCHN who received multimodal treatment including palliative therapy with cetuximab. Both patients developed severe thoracic and cervicothoracic pain following treatment. In both cases, extensive paraspinal abscess formation proved to be the underlying cause. One patient was treated conservatively; the other one had to undergo surgical intervention. Conclusions: Awareness of multifaceted therapy-related complications is mandatory when patients receive multimodal treatment including targeted therapies. Unexplained pain syndromes in this context should raise suspicions concerning possible infectious complications and should lead to early use of magnetic resonance imaging.

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“…To our knowledge, these are the first predictive tools that have been developed for moderate to severe diarrhea and skin in patients receiving targeted therapy with lapatinib. Diarrhea and skin rash are both associated with substantial morbidity affecting patient quality of life and high cost to the health care system [7, 8, 26, 27]. Therefore, the ability to preempt these episodes with the use of validated mathematical algorithms will improve patient quality of life, reduce pain, and suffering and avoid unnecessary health care expenditures.…”

Section: Discussionmentioning

confidence: 99%

Development of prediction tools for diarrhea and rash in breast cancer patients receiving lapatinib in combination with capecitabine

Dranitsaris

Lacouture

2014

Breast Cancer Res Treat

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Lapatinib and capecitabine (L-CAP) is effective in HER-2 positive patients with metastatic breast cancer (MBC). However, moderate to severe diarrhea and rash (≥ grade 2) are problematic dose limiting toxicities. Since risk may vary over the course of therapy, we developed repeated measures models to predict the risk of ≥ grade 2 diarrhea and rash prior to each cycle of L-CAP. Data from 197 patients who received the L-CAP as part of a clinical trial were reviewed (Cameron, Breast Cancer Res Treat 112:533–543, 2008). Generalized estimating equations were used to develop the risk models using a backward elimination process. Risk scoring algorithms were then derived from the final model coefficients. Finally, a receiver operating characteristic curve (ROC) analysis was undertaken to measure the predictive accuracy of the scoring algorithms. Patient age, presence of skin metastases at baseline, treatment being initiated in the spring, earlier cycles, and grade I diarrhea in the prior cycle were identified as being significant predictors for ≥ grade 2 diarrhea. The ROC analysis indicated good predictive accuracy for the diarrhea algorithm with an area under the curve of 0.78 (95 %CI: 0.72–0.82). Prior to each cycle of therapy, patients with risk scores > 125 units would be considered at high risk for developing ≥ grade 2 diarrhea. A similar prediction index was also derived in the case of ≥ grade 2 rash. Our models provide patient-specific risk information that could be helpful in assessing the risks and benefits of L-CAP in the MBC patients.

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Economic Burden of Dermatologic Adverse Events Induced by Molecularly Targeted Cancer Agents

Abstract: Objective: To report the financial impact of diagnosing and treating the dermatologic toxicities (dTs) that develop in patients receiving targeted anticancer therapies.Design: Single-center retrospective and prospective medical record data extraction.

Cited by 42 publications

References 34 publications

A systematic review of observational studies evaluating costs of adverse drug reactions

A systematic review of observational studies evaluating costs of adverse drug reactions

Severe Pain Due to Paraspinal Abscess Formation in Two Patients with Squamous-Cell Carcinoma of the Head and Neck after Multimodal Treatment Including Cetuximab

Development of prediction tools for diarrhea and rash in breast cancer patients receiving lapatinib in combination with capecitabine

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