Economic burden of toxicities associated with treating metastatic melanoma in eight countries

Wehler, Elizabeth; Zhao, Zhongyun; Bilir, S. Pinar; Munakata, Julie; Barber, Beth

doi:10.1007/s10198-015-0757-y

Cited by 39 publications

(40 citation statements)

References 22 publications

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“…The study by Nuijten et al was considered as a duplicate of the study by Banz et al The literature research was then extended to the management of AEs related to treatment in melanoma, considering that the management of grades 3 and 4 AEs does not depend on the underlying disease. Two studies were identified 19 , 20 and none was excluded. French experts were asked to complete data when information was lacking.…”

Section: Methodsmentioning

confidence: 99%

Cost analysis of adverse events associated with non-small cell lung cancer management in France

Chouaïd

Loirat

Clay

et al. 2017

CEOR

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BackgroundAdverse events (AEs) related to medical treatments in non-small cell lung cancer (NSCLC) are frequent and need an appropriate costing in health economic models. Nevertheless, data on costs associated with AEs in NSCLC are scarce, particularly since the development of immunotherapy with specific immune-related AEs.ObjectiveTo estimate the costs of grades 3 and 4 AEs related to NSCLC treatments including immunotherapy in France.MethodsGrades 3 and 4 AEs related to treatment and reported in at least 1% of patients in Phase III clinical trials for erlotinib, ramucirumab plus docetaxel, docetaxel, pemetrexed plus carboplatin plus bevacizumab, platinum-based chemotherapies, nivolumab and pembrolizumab were identified. When no cost evaluation was reported in literature, estimates on standard treatments and medical resource use for each AE were obtained thanks to an expert panel. Total cost per AE was calculated from a French national health insurance perspective and updated in 2017 Euros. Hospital stay costs were estimated based on public and private weighted tariffs and data from the French Medical Information System (Programme de Médicalisation des Systèmes d’Information). Costs of tests, consultations and treatments were calculated based on national reimbursement tariffs.ResultsOverall, costs of grades 3 and 4 AEs related to treatment ranged from €46 per event to €7,742 per year. Fourteen out of 24 AEs identified had a mean estimated cost over €2,000. The highest mean costs were related to type 1 diabetes (€7,742 per year) followed by pneumonitis (€5,786 per event), anemia (€5,752 per event), dehydration (€5,207 per event) and anorexia (€4,349 per event). Costs were mostly driven by hospitalization costs.ConclusionAmong the AEs identified, a majority appeared to have an important economic impact, with a management cost of at least €2,000 per event mainly driven by hospitalization costs. This study may be of interest for economic evaluations of new interventions in NSCLC.

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Section: Methodsmentioning

confidence: 99%

Cost analysis of adverse events associated with non-small cell lung cancer management in France

Chouaïd

Loirat

Clay

et al. 2017

CEOR

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“…The cost parameters were associated with the management and treatment of adverse events in the patients affected by metastatic melanoma, following the administration of one of the above-mentioned innovative treatments. Table 4 reports the cost estimates obtained from two studies through a systematic review of the literature carried out internationally [27,28]. For the adverse event 'pneumonia', the model takes into account the Italian national tariff associated with DRG 90 (simple pneumonia and pleurisy, age > 17 years, without complications) [29].…”

Section: Cost Parametersmentioning

confidence: 99%

Cost Estimate of Immune-Related Adverse Reactions Associated with Innovative Treatments of Metastatic Melanoma

et al. 2018

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“…Comparing PEMBRO with IPI in controlled trials, PEMBRO as a single agent demonstrated prolonged progression-free and overall survival with fewer high-grade adverse events 6 , and NIVO administered in combination with IPI has better progression free survival and higher rates of objective response than with IPI alone 7 . Costs related to toxicity can be substantial, particularly with respect to inpatient management of AEs [11][12][13] . In clinical trials, reported grade 3 or 4 treatment-related adverse events (AEs) are 59% with IPI þ NIVO in combination and 17% with PEMBRO as a single agent 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Hospitalization and emergency department utilization in patients with advanced melanoma receiving pembrolizumab versus ipilimumab plus nivolumab in US academic centers

Joseph

Shillington

Lee

et al. 2019

Journal of Medical Economics

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Background: Both pembrolizumab (PEMBRO) and ipilimumab þ nivolumab (IPI þ NIVO) are FDAapproved immunotherapy regimens for advanced melanoma (AM). Each regimen has different toxicity profiles potentially impacting healthcare resource utilization (HCRU). This study compared real-world hospitalization and emergency department (ED) utilization within 12 months of therapy initiation of each regimen. Methods: A retrospective cohort study was conducted in AM patients 18 years old initiating PEMBRO or IPI þ NIVO between January 1, 2016-December 30, 2017. Patients were identified from 12 US-based academic and satellite centers. All-cause hospitalization ED visits were identified. These events were used to calculate rates per 1,000 patient months. Utilization between groups was compared using multivariate logistic regression. Results: In total, 400 patients were included (200 PEMBRO, 200 IPI þ NIVO). PEMBRO vs IPI þ NIVO patients had poorer Eastern Cooperative Group (ECOG) performance status, 29% 2-4, vs 12% (p < .001); more diabetes, 21% vs 13% (p ¼ .045); were more often PD-L1 expression positive, 77% vs 63% (p ¼ .011); and less likely BRAF mutant, 35% vs 50% (p ¼ .003). The proportion with more than one hospitalization over 12 months was 17% PEMBRO vs 24% IPI þ NIVO. Less than 2% had more than one admission and none had more than two. Unadjusted mean (SD) hospitalizations per 1,000 patient-months were 16 (37) and 20 (38), PEMBRO and IPI þ NIVO, respectively. Adjusted odds ratio for hospitalization was 0.6 (95% CI ¼ 0.3-0.9; p ¼ .027) for PEMBRO vs IPI þ NIVO. ED visits occurred in 18% vs 21%, PEMBRO and IPI þ NIVO, respectively, 0.7 (p ¼ .186). Conclusions: PEMBRO patients had a significantly lower probability of hospitalization through 12 months vs IPI þ NIVO. The probability of ED visits did not differ.

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Economic burden of toxicities associated with treating metastatic melanoma in eight countries

Cited by 39 publications

References 22 publications

Cost analysis of adverse events associated with non-small cell lung cancer management in France

Cost analysis of adverse events associated with non-small cell lung cancer management in France

Cost Estimate of Immune-Related Adverse Reactions Associated with Innovative Treatments of Metastatic Melanoma

Hospitalization and emergency department utilization in patients with advanced melanoma receiving pembrolizumab versus ipilimumab plus nivolumab in US academic centers

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