Economic impact of disease progression following front-line therapy in classical Hodgkin lymphoma

Tseng, Wan-Yu; Yap, Mark; Rembert, Debra; Patt, Debra A.

doi:10.3109/10428194.2015.1030639

Cited by 14 publications

(14 citation statements)

References 13 publications

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“…These findings are important, as contemporary evidence on the treatment and costs of caring for patients with RRHL in routine clinical practice in the post-BV era. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

“…Chemotherapy and transplant costs are key contributors to the economic burden, particularly for patients with RRHL. In a previous retrospective study, Yasenchak et al[ 12 ] estimated the mean total cost at 21,956 (USD 2007) among adult HL patients treated in first-line, 77,219 USD among those treated in second-line, and 59,442 USD among those treated in third-line. That study was from the pre-BV era, however, and until the present study, more contemporary estimates that account for costlier therapies (such as BV, rituximab, and allo-SCT) had not yet been presented.…”

Section: Discussionmentioning

confidence: 99%

“…[ 10 , 11 ] However, limited real-world data exist on the management of patients with RRHL, or their costs of care, in routine clinical practice in the post-BV era. [ 12 ] Contemporary estimates are required to help understand the current economic burden of RRHL, and also to provide context for clinical and economic costs and benefits of new treatments for RRHL.…”

Section: Introductionmentioning

confidence: 99%

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Treatment patterns and costs of care for patients with relapsed and refractory Hodgkin lymphoma treated with brentuximab vedotin in the United States: A retrospective cohort study

Szabo¹,

Hirji

Johnston³

et al. 2017

PLoS ONE

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ObjectivesAlthough brentuximab vedotin (BV) has changed the management of patients with relapsed or refractory Hodgkin lymphoma (RRHL), little information is available on routine clinical practice. We identified treatment patterns and costs of care among RRHL patients in the United States (US) treated with BV.MethodsA retrospective observational study of adults initiating BV for RRHL from 2011–2015, with ≥6 months of data prior to and following BV initiation, was conducted. Treatments were classified based on dispensations and chemotherapy administration. Median total and monthly costs were estimated based on all-cause healthcare resource use in 2015 US dollars (USD).ResultsThe cohort comprised 289 patients (59% male; mean age at diagnosis, 42 years) with a mean follow-up of 250 weeks. Eleven percent had BV salvage therapy prior to ASCT, and 32% had BV for a relapse post-ASCT. 43% received treatment post-BV, most commonly allogeneic stem cell transplant (SCT) and bendamustine (both 10.2%). Median (IQR) total costs from BV initiation to censoring were 294,790 (142,110–483,360) USD; and were highest among those treated with BV prior to ASCT (up to 421,900 [300,940–778,970] USD). Median monthly costs were almost 20,000 USD per month, and up to 25,000 USD per month among those with BV and ASCT. Medications were the greatest driver of median monthly costs.ConclusionsMedian total all-cause costs were almost 300,000 USD, and median monthly costs approximately 20,000 USD, per patient treated. Patients requiring treatment following BV continue to incur high costs, highlighting the economic burden associated with managing patients in the RRHL setting.

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“…These findings are important, as contemporary evidence on the treatment and costs of caring for patients with RRHL in routine clinical practice in the post-BV era. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment patterns and costs of care for patients with relapsed and refractory Hodgkin lymphoma treated with brentuximab vedotin in the United States: A retrospective cohort study

Szabo¹,

Hirji

Johnston³

et al. 2017

PLoS ONE

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“… 13 The PPPM costs by line of therapy (frontline, second line, third line) in the current analysis are consistent with those of prior literature, depicting an increase in costs from line one to line two and a decrease from line two to line three. 12 , 21 The higher cost in the second-line therapy is likely due to the higher prevalence of SCT during second-line therapy (first salvage therapy) compared to first-line and third-line (second salvage therapies) therapies. As the cost of SCT was not directly measured in this current study, further research is needed to determine if SCT is the cause for the higher cost of second-line therapy.…”

Section: Discussionmentioning

confidence: 99%

Real-world analysis of cost, health care resource utilization, and supportive care in Hodgkin lymphoma patients with frontline failure

Bonafede¹,

Feliciano²,

Cai³

et al. 2018

CEOR

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PurposeThe purpose of this study was to evaluate the economic burden of frontline failure (FLF) among classical Hodgkin lymphoma (HL) patients during and after treatment.Patients and methodsThe population consisted of adult HL patients identified from January 2010 through September 2015 without any other primary cancer prior to HL diagnosis, who also had a frontline (FL) regimen indicative of curative intent. Patients were characterized as FLF (those who restart, switch to any chemotherapy; had a hematopoietic stem cell transplant; or newly initiated radiation therapy [RT] after discontinuing FL) or non-FLF (those not considered as FLF). Direct health care utilization and expenditures were measured over both fixed and variable length follow-up periods and during FL therapy.ResultsThere were 77 FLF and 602 non-FLF patients who met the final inclusion criteria. FLF and non-FLF patients were demographically similar with mean age 38.5 years and 47.5% females. Average per patient per month (PPPM) costs were significantly higher for FLF patients during all follow-up (US$20,266 vs US$7,772, P<0.05). Annual total expenditures were significantly higher among FLF patients (US$198,388) vs non-FLF patients (US$37,549). FLF (vs non-FLF) patients had a significantly shorter duration of FL therapy (116 vs 131 days, P=0.024) and higher total PPPM expenditures during FL (US$29,040 vs US$16,369, P<0.05). Annual cost varied by failure type with those who failed due to restart incurring the highest cost (US$269,189) and those who switched incurring the lowest cost (US$46,951). FLF patients had a significantly greater utilization in every health care resource category during follow-up.ConclusionFLF (vs non-FLF) patients utilized substantially more health care resources and incurred a substantially higher economic burden. Over 5 years, FLF patients with at least two lines of treatment were projected to incur US$535,846 of health care costs. Further research is needed to determine optimal treatment that could reduce the risk of progression, need for treatment after FL, and enhance long-term clinical and economic outcomes.

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“…Salvage therapy and transplantation have been shown to add significant costs to HL management, underscoring the importance of optimal management of outcomes to avoid disease progression. Yasenchak et al [22] evaluated the economic impact of disease progression after first-line therapy in patients with classic HL within a large US oncology network and found that second and third lines of therapy were 2.7-3.5 times more costly than first-line treatment ($21,956, $77,219, and $59,442 for first, second, and third line, respectively). The current study reported that total costs were $167,152 for BV treatment, with a PPPM cost of $30,434.…”

Section: Discussionmentioning

confidence: 99%

Treatment patterns, health care resource utilization, and costs in patients with relapsed/refractory Hodgkin lymphoma treated with brentuximab vedotin

Shao

Liu

Zhou

et al. 2018

Leukemia & Lymphoma

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Data are limited on the real-world utilization and costs of brentuximab vedotin (BV) among patients with relapsed/refractory Hodgkin lymphoma (rrHL) in the United States. A total of 219 BV patients identified from the Truven MarketScan V R databases were followed up for a median of 2.9 years before and 1.0 year after initiation of BV. Of these patients, 109 (50.6%) received systemic therapy after BV (post-BV ST). Median duration of treatment was short for BV (2.1 months) and post-BV ST treatment (1.3 months); time to next treatment was 6.2 and 9.1 months, respectively. Average total US dollar 2014 costs/person for BV and post-BV ST line of therapy were $167,152 and $132,115, respectively; mean per-patient-per-month costs for BV and post-BV ST were $30,434 and $29,138, respectively. Findings underscore the unmet medical need and substantial economic burden in BV-treated patients with rrHL.

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Economic impact of disease progression following front-line therapy in classical Hodgkin lymphoma

Cited by 14 publications

References 13 publications

Treatment patterns and costs of care for patients with relapsed and refractory Hodgkin lymphoma treated with brentuximab vedotin in the United States: A retrospective cohort study

Treatment patterns and costs of care for patients with relapsed and refractory Hodgkin lymphoma treated with brentuximab vedotin in the United States: A retrospective cohort study

Real-world analysis of cost, health care resource utilization, and supportive care in Hodgkin lymphoma patients with frontline failure

Treatment patterns, health care resource utilization, and costs in patients with relapsed/refractory Hodgkin lymphoma treated with brentuximab vedotin

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