Forecasting Treatment Costs of Follicular Lymphoma: A Population-Based Discrete Event Simulation

Abstract

A147patient population. Based on a representative population-based patient-cohort, the objective of this study was to develop a decision model that could reflect realworld practice and predict the costs throughout treatment pathway. Methods: All patients newly diagnosed with FL in the UK's population-based Haematological Malignancy Research Network (www.hmrn.org) between 2004 and 2011 were followed until 2014 (n= 741). The mapped treatment pathways, alongside cost information derived from the National Tariff 2013/14, were incorporated into a discrete event simulation in order to reflect the heterogeneity of clinical characteristics, such as stage, and treatment options. Results: The annual cost of treating FL across the UK (population ~ 64 million) was estimated to be around £17 million. The predicted mean cost per patient from diagnosis to death was £10,202. Based on the initial treatment decision average costs were; £17,054 for those treated with chemotherapy (46%), £4,651 for those treated with radiotherapy (12%), and £2,185 for those managed by "watch-and-wait" (42%). The model's predicted costs per patient captured 95% of the actual costs calculated from empirical data, supporting the validity of the model. ConClusions: This is the first modelling study using 'real world' evidence to predict costs of entire FL treatment pathways. As several expensive new technologies/treatments for FL are on the horizon, future application of the model developed here could be used to assess their economic impacts and support healthcare decision makers, especially in the era of personalised medicine.

Cost-Effectiveness Analyses, Costs and Resource Use, and Health-Related Quality of Life in Patients with Follicular or Marginal Zone Lymphoma: Systematic Reviews

“…Three studies and two abstracts in FL met the eligibility criteria for final inclusion. One study assessed patients who received prior treatment [30], while the other four included only treatment-naïve patients [26,[31][32][33]. Treatment regimens, when reported, all incorporated the use of R in monotherapy or combination.…”

“…Treatment regimens, when reported, all incorporated the use of R in monotherapy or combination. The time horizon ranged from 1 year [30] to a lifetime [32,33]. Studies were conducted from the health care payer perspective, when reported [30][31][32]34].…”

“…Table 4 provides direct cost results, with direct drug and non-drug costs further depicted in electronic supplementary Table 5. Two studies [32,33] reported the total mean cost over a lifetime. The reported lifetime costs from diagnosis until death for patients receiving R-CHOP, R + chemotherapy, and R alone were $108,000 (USD; 2014), $114,800, and $130,300, respectively [32].…”

“…The reported lifetime costs from diagnosis until death for patients receiving R-CHOP, R + chemotherapy, and R alone were $108,000 (USD; 2014), $114,800, and $130,300, respectively [32]. UK patients under a watch-and-wait strategy (£2185) and radiotherapy (£4651) were estimated to incur less costs than patients receiving chemotherapy (£17,054) as an initial treatment [33]. Annual total mean costs for patients with disease progression were $30,890, compared with $8704 for patients without disease progression [30].…”