Health Care Resource Utilization and Associated Costs Among Metastatic Cutaneous Melanoma Patients Treated with Ipilimumab (INTUITION Study)

McArthur, Grant A.; Mohr, Peter; Ascierto, Paolo A.; Arance, Ana; Hernaez, Ana Banos; Kaskel, Peter; Weichenthal, Michael; Shinde, Reshma; Stevinson, Kendall

doi:10.1634/theoncologist.2016-0272

Cited by 16 publications

(15 citation statements)

References 25 publications

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“…Before 2011, when a series of innovative drugs in metastatic melanoma patients began reaching the market, medical costs were lower due to limited treatment options [19][20][21]. The cost associated with new therapies for melanoma both immunotherapies and targeted therapies, are the major driver of an increase in the total cost of managing melanoma compared to the situation before 2011 [30].…”

Section: Discussionmentioning

confidence: 99%

Disease Management and Resource Use for the Management of Melanoma stage IIIc or IV Positive for BRAF V600 Mutations in Greece

Carayanni¹,

Gogas²,

Bafaloukos³

et al. 2021

Med Clin Res Open Access

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Objective: Melanoma is one of the most aggressive cancers and is responsible for the majority of skin cancer deaths, with the presence of metastases prognostic for poor survival. At a time when most cancer incidences are falling, the annual incidence of melanoma has risen as rapidly as 4-6% in many European countries, with a substantial economic burden in advanced stages. The objective of this study is the investigation of treatment pathways and healthcare resource use related to advanced BRAF-mutated melanoma in Greece. Methods: This study is based on the information collected by an expert panel comprising of 3 oncologists of major public and private melanoma clinics around Greece. A 3-round survey was undertaken, according to a modified Delphi method. The treatment phases studied were: pre-progression; disease progression and terminal care. Oncology drug costs, medical visits, laboratory tests, imaging examinations, hospitalization and concomitant medications were the resources considered in the context of the Greek National Services Organization (EOPYY). Results: Τhe most common management scenario (80% of cases) in Greece for patients of stage IV BRAF V600 mutated melanoma was: targeted therapies as first line treatment at 95%, followed by immunotherapies at 100% as second line as well as third line treatment at 65% of cases. The weighted annual cost of treatment was 89.215,78 €, (90%CI:62,451.05; 115,980.51) for first line treatment at list price and around 41.584,50 (90%CI:29,109.15; 54,059.85) based on the negotiated price. At second line, the cost of treatment has been estimated between 15,704.272 (90%CI:10,992.990; 20,415.553) and 19,800.92€, (90%CI: 16,489; 30,622) for the two most common management scenarios for immunotherapies. For third line treatment the cost was 37,778.93 (90%CI 26,445.25; 49,112.61€) for the mostly used management scenario (50% ipilimumab). Conclusions: Μetastatic BRAF mutant melanoma requires prolonged and costly treatment with new therapies shown to substantially increase life expectancy. Identifying the appropriate treatment options in order to optimize health outcomes should be an important priority in healthcare system.

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Section: Discussionmentioning

confidence: 99%

Disease Management and Resource Use for the Management of Melanoma stage IIIc or IV Positive for BRAF V600 Mutations in Greece

Carayanni¹,

Gogas²,

Bafaloukos³

et al. 2021

Med Clin Res Open Access

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“…Drug administration costs per dose were estimated from rates extracted from local Hong Kong data. The model also incorporated costs for routine oncology office visits, lab tests, scans and other resources used in the different health states based on the INTUITION study (see Table 1) [11]. The model also included a one-time cost of terminal care to approximate health care cost in the last 6 months of life as estimated in Wong et al 2007 [12].…”

Section: Costsmentioning

confidence: 99%

Cost-effectiveness analysis of pembrolizumab compared to standard of care as first line treatment for patients with advanced melanoma in Hong Kong

Loong

Wong

Leung

et al. 2020

Cost Eff Resour Alloc

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Background: Pembrolizumab has been shown to improve overall survival (OS) and progression free survival (PFS) compared to ipilimumab in patients with ipilimumab-naïve advanced melanoma; however, there are no published data on the cost-effectiveness for pembrolizumab compared to standard-of-care treatments currently used in Hong Kong for advanced melanoma. Methods: A partitioned-survival model based on data from a recent randomized phase 3 study (KEYNOTE-006) and meta-analysis was used to derive time in PFS, OS, and post-progression survival for pembrolizumab and chemotherapy, such as dacarbazine (DTIC), temozolomide (TMZ), and the paclitaxel-carboplatin combination (PC). A combination of clinical trial data, published data, results of meta-analysis, and melanoma registry data was used to extrapolate PFS and OS curves. The base-case time horizon for the model was 30 years with costs and health outcomes discounted at a rate of 5% per year. Individual patient level data on utilities and frequencies of adverse events were obtained from the final analysis of KEYNOTE-006 (cut-off date: 3-Dec-15) for pembrolizumab. Cost data included drug acquisition, treatment administration, adverse event management, and clinical management of advanced melanoma. The distribution of patient weight from the Hong Kong population was applied to calculate the drug costs. Analyses were performed from a payer's perspective. The incremental cost effectiveness ratio (ICER) expressed as cost in US Dollars (USD) per quality-adjusted life years (QALYs) was the main outcome. Results: In base-case scenario, the ICER for pembrolizumab as a first-line treatment for advanced melanoma was USD49,232 compared to DTIC, with the ICER values lower than cost-effectiveness threshold in Hong Kong. Results comparing pembrolizumab to TMZ and to PC were similar to that when compared to DTIC. Probability sensitivity analyses showed that 99% of the simulated ICERs were below three times the Gross Domestic Product (GDP) per capita for Hong Kong (currently at $119,274//QALY threshold). In a scenario analysis comparing pembrolizumab with ipilimumab, the estimated ICER was USD8,904. Conclusions: Pembrolizumab is cost-effective relative to chemotherapy (DTIC, TMZ and PC), and highly-cost-effective compared to ipilimumab, for the first-line treatment of advanced melanoma in Hong Kong.

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“…The Swedish study estimated higher costs, despite expensive new drugs used in patients with metastases not being included. Another multicentre international study 8 conducted after the introduction of ipilimumab on realworld data only for advanced-stage disease showed that the average costs of care for patients with melanoma are lower in Italy than in other European countries: €11 696 in Germany, €6748 in Spain and €3746 in Italy. These differences may be due, for example, to different national health policies and price negotiations of drugs or devices, and to the different overall production costs of hospital or ambulatory care.…”

Section: Conflicts Of Interest: None To Declarementioning

confidence: 99%

Real‐world data for direct stage‐specific costs of melanoma healthcare

et al. 2020

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A et al. [German version of the Skin Shame Scale (SSS-24). Validation with dermatological patients and dermatologically healthy individuals]. Hautarzt 2020; 71:124-9. [in German]. 6 Scott C. Understanding psychodermatological distress: constructing a skin shame scale. BA Thesis, University of Sheffield, 2004. 7 Kleyn CE, McKie S, Ross AR et al. Diminished neural and cognitive responses to facial expressions of disgust in patients with psoriasis: a functional magnetic resonance imaging study.

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Health Care Resource Utilization and Associated Costs Among Metastatic Cutaneous Melanoma Patients Treated with Ipilimumab (INTUITION Study)

Abstract: The objective of this study was to describe health care resource utilization and health care costs associated with the management of advanced melanoma patients receiving ipilimumab.

Cited by 16 publications

References 25 publications

Disease Management and Resource Use for the Management of Melanoma stage IIIc or IV Positive for BRAF V600 Mutations in Greece

Disease Management and Resource Use for the Management of Melanoma stage IIIc or IV Positive for BRAF V600 Mutations in Greece

Cost-effectiveness analysis of pembrolizumab compared to standard of care as first line treatment for patients with advanced melanoma in Hong Kong

Real‐world data for direct stage‐specific costs of melanoma healthcare

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