Healthcare resource utilization in patients with metastatic melanoma receiving first-line therapy with dabrafenib + trametinib versus nivolumab or pembrolizumab monotherapy

Ghate, Sameer; Ionescu‐Ittu, Raluca; Burne, Rebecca; Ndife, Briana; Laliberté, François; Nakasato, Antonio; Duh, Mei Sheng

doi:10.1080/03007995.2018.1501351

Cited by 7 publications

(7 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since cancer staging information is not available in administrative claims, we used an operational algorithm similarly used in previous observational studies to identify patients with metastatic melanoma. 8,[14][15][16][17][18][19] Figure 1 illustrates a graphical representation of the algorithm and the implemented study methods, adapted from the Repeat Initiative's recommendations on study design visualizations. 20 We defined a case of metastatic melanoma as an initiator of one of the commonly used first-line therapies available over the course of the study period.…”

Section: Data Source and Study Populationmentioning

confidence: 99%

“…Patients were required to have at least one inpatient or two outpatient diagnoses of malignant melanoma using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and ICD-10-CM codes during the 6 months prior to the index date (baseline period) on separate days within 30 days, and at least one inpatient or outpatient medical encounter with a diagnosis of a secondary malignant neoplasm in primary position , 30 days before, or 60 days after a melanoma diagnosis. 8,[14][15][16][17][18][19] Patients were also required to have at least 6 months continuous insurance eligibility before and at least 1 month continuous eligibility after the index date to ensure a minimum duration of analyzable information on health care resource use. Patients were excluded if they had other primary malignant tumors during baseline (Data Supplement), were covered by a capitated health plan or one without prescription benefits at index date, and had missing demographic or health plan information.…”

Section: Data Source and Study Populationmentioning

confidence: 99%

See 1 more Smart Citation

Health Care Utilization and Costs Associated With Systemic First-Line Metastatic Melanoma Therapies in the United States

Boemmel-Wegmann

Brown

Diaby

et al. 2022

JCO Oncology Practice

View full text Add to dashboard Cite

PURPOSE: US Food and Drug Administration approvals of immune checkpoint inhibitors and targeted therapies revolutionized the treatment of metastatic melanoma. Our aim was to assess health care resource utilization and costs for patients with metastatic melanoma treated with systemic therapies in first line between January 2012 and December 2017. METHODS: We conducted a retrospective cohort study of patients with metastatic melanoma using MarketScan data. We included patients diagnosed with melanoma and secondary malignant neoplasm who used pembrolizumab, nivolumab, ipilimumab, ipilimumab plus nivolumab, BRAF-inhibitor (BRAF-i) plus MEK inhibitor (MEK-i), BRAF-i or MEK-i monotherapy, or chemotherapy in first line. We compared health care utilization and costs per patient per month (PPPM) using two-part and generalized linear models. RESULTS: We identified 1,870 patients, including 185 pembrolizumab, 103 nivolumab, 689 ipilimumab, 185 nivolumab plus ipilimumab, 214 BRAF-i plus MEK-i, 240 BRAF-i or MEK-i monotherapy, and 254 chemotherapy users. Highest PPPM rates of hospitalizations, emergency room visits, and outpatient visits were observed in patients with ipilimumab plus nivolumab therapy (adjusted difference v pembrolizumab [aDiff], 0.18, 0.12, and 0.88, respectively; all P < .001). Ipilimumab monotherapy users (aDiff, 0.07 and 0.93; all P < .001) and chemotherapy users (aDiff, 0.10 and 2.63; all P < .001) showed higher PPPM rates of hospitalizations and outpatient visits compared with pembrolizumab users, respectively. Utilization rates in nivolumab, BRAF-i plus MEK-i, and BRAF-i or MEK-i groups were similar to the pembrolizumab group. Highest PPPM total costs and drug-related costs were observed in the ipilimumab group ($80,139 US dollars [USD] and $70,051 USD; all P < .001), followed by the ipilimumab plus nivolumab ($71,689 USD and $56,217 USD; all P < .001) and the BRAF-i plus MEK-i group ($31,184 USD and $19,648 USD; all P < .001). PPPM costs in the nivolumab group were similar to the pembrolizumab group. CONCLUSION: Significant differences in health care resource utilization and costs were found across first-line metastatic melanoma regimens. Utilization rates were highest in patients using ipilimumab-containing therapies. High drug costs constituted a major fraction of total PPPM health care costs.

show abstract

Section: Data Source and Study Populationmentioning

confidence: 99%

Section: Data Source and Study Populationmentioning

confidence: 99%

Health Care Utilization and Costs Associated With Systemic First-Line Metastatic Melanoma Therapies in the United States

Boemmel-Wegmann

Brown

Diaby

et al. 2022

JCO Oncology Practice

View full text Add to dashboard Cite

show abstract

“…2 Experience with ipilimumab monotherapy has been reported, although this has been limited to commercially insured populations and/or not limited to the first-line therapy setting. 16,17 A recent analysis by Ghate et al (2018), also conducted among commercially insured patients, assessed HCRU and found no difference in inpatient hospitalizations and emergency department (ED) visits between patients treated with first-line dabrafenib plus trametinib and patients treated with first-line nivolumab or pembrolizumab monotherapy (2.3 vs. 2.2 inpatient hospitalizations per patient-year, respectively; 1.6 vs. 2.1 ED visits per patient-year, respectively). 18 While others have modeled U.S. costs among patients with metastatic melanoma treated with immunotherapies, few data exist on a limited set of immunotherapies.…”

Section: What This Study Addsmentioning

confidence: 99%

“…16,17 A recent analysis by Ghate et al (2018), also conducted among commercially insured patients, assessed HCRU and found no difference in inpatient hospitalizations and emergency department (ED) visits between patients treated with first-line dabrafenib plus trametinib and patients treated with first-line nivolumab or pembrolizumab monotherapy (2.3 vs. 2.2 inpatient hospitalizations per patient-year, respectively; 1.6 vs. 2.1 ED visits per patient-year, respectively). 18 While others have modeled U.S. costs among patients with metastatic melanoma treated with immunotherapies, few data exist on a limited set of immunotherapies. [18][19][20][21] Very little information is available on metastatic melanoma patients treated with all currently available immunotherapies and targeted therapies.…”

Section: What This Study Addsmentioning

confidence: 99%

See 1 more Smart Citation

Health Care Resource Utilization and Costs in First-Line Treatments for Patients with Metastatic Melanoma in the United States

Klink

Chmielowski

Feinberg

et al. 2019

JMCP

View full text Add to dashboard Cite

BACKGROUND: The treatment landscape for patients with metastatic melanoma has changed dramatically with the introduction of novel therapies, such as targeted therapies and immunotherapies, in recent years. Health care resource utilization (HCRU) and cost data are needed to further evaluate these treatments in a value-based health care system. OBJECTIVE: To examine HCRU and total cost of care among U.S. metastatic melanoma patients treated with first-line systemic therapies, including immunotherapies, targeted therapies, and chemotherapy.METHODS: A retrospective observational study was conducted using a U.S. claims database. Adults with ≥ 2 claims for melanoma and ≥ 1 claim for metastasis between January 1, 2012, and June 30, 2017, were identified. Patients had pharmacy and medical enrollment ≥ 6 months before and ≥ 3 months following first-line treatment start. Per patient per month (PPPM) HCRU and costs were calculated by first-line treatment drug class: PD-1 inhibitors, CTLA-4 inhibitors, CTLA-4 + PD-1 combination, BRAF monotherapy, BRAF + MEK combination, and chemotherapy. Adjusted odds ratios (ORs) for HCRU were estimated by logistic regressions and adjusted costs were estimated by generalized linear models using log-link with gamma distribution to control for differences in patient characteristics across groups. RESULTS: Among 1,599 metastatic melanoma patients (PD-1, n = 255; CTLA-4, n = 555; CTLA-4 + PD-1, n = 88; BRAF, n = 210; BRAF + MEK, n=102; chemotherapy=389), mean age ranged from 59-68 years, and the majority were male (62%). Any hospitalization during first-line treatment was less frequent among PD-1-treated patients (25.9%) compared with 34.7%-45.5% of all other groups (all P < 0.05). PPPM hospitalizations were lowest in PD-1 (0.06) compared with 0.09-0.16 across all other groups (all P < 0.05), and PPPM emergency department (ED) visits were lowest in PD-1 (0.09) compared with 0.13-0.18 across all other groups (all P < 0.05), except for BRAF + MEK (0.14, P = 0.08). CTLA-4, CTLA-4 + PD-1, and BRAF + MEK had increased odds of hospitalization compared to PD-1 (adjusted ORs = 2.10, 2.35, 2.15, respectively; all P < 0.05

show abstract

Comparison of healthcare resource utilization and costs of patients with HR+/HER2- advanced breast cancer treated with ribociclib versus other CDK4/6 inhibitors

Burne

Balu²,

Guérin

et al. 2021

Journal of Medical Economics

Self Cite

View full text Add to dashboard Cite

This study was sponsored by Novartis Pharmaceuticals Corporation. The study sponsor was involved in several aspects of the research including the study design, the interpretation of data, the writing of the manuscript, and the decision to submit the manuscript for publication. Declaration of Financial/Other InterestsSB, RS, and MLP are employees and stockholders of Novartis Pharmaceuticals Corporation. RB, AG, and RB are employees of Analysis Group, Inc., a consulting company that has provided paid consulting services to Novartis Pharmaceuticals Corporation.

show abstract

Healthcare resource utilization in patients with metastatic melanoma receiving first-line therapy with dabrafenib + trametinib versus nivolumab or pembrolizumab monotherapy

Abstract: HRU during 1 L therapy was generally similar between patients initiated on D + T and N/P. Nonetheless, patients initiated on N/P had more outpatient visits, including more outpatient visits for reasons unrelated to drug administration.

Cited by 7 publications

References 29 publications

Health Care Utilization and Costs Associated With Systemic First-Line Metastatic Melanoma Therapies in the United States

Health Care Utilization and Costs Associated With Systemic First-Line Metastatic Melanoma Therapies in the United States

Health Care Resource Utilization and Costs in First-Line Treatments for Patients with Metastatic Melanoma in the United States

Comparison of healthcare resource utilization and costs of patients with HR+/HER2- advanced breast cancer treated with ribociclib versus other CDK4/6 inhibitors

Contact Info

Product

Resources

About