Pcn22 Costs of Common Treatment Options for Indolent Follicular Non-Hodgkin's Lymphoma

Agthoven, Michel van; Hagenbeek, Anton; Groot, CA Uyl-de

doi:10.1016/s1098-3015(10)67260-9

Cited by 8 publications

(13 citation statements)

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“…It lends itself to incorporation of economic evidence when evaluating the impact of advances in the field and understanding their cost consequences. 5,6 In clinical practice, a common dilemma is how to factor in the concern for healthcare expenses into the clinical decision-making process (eg, when recommending a third line treatment for steroid refractory GVHD, considering options for a patient who relapses with acute leukemia within the first month after HCT or managing a patient with chronic GVHD who cannot afford medications/tests because of lack of insurance). This adds to the daily struggle between delivering care and considering the downstream effects on resource use for the healthcare system as well as the consequences on patient quality of life and financial burden.…”

Section: Why Do Costs Matter?mentioning

confidence: 99%

Economics of hematopoietic cell transplantation

Khera

Zeliadt

Lee

2012

Blood

147

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Given the rapidly rising healthcare costs, it is important to understand the economic costs of hematopoietic cell transplantation (HCT), a procedure that is being used more frequently in the treatment of various hematologic disorders. Studies have reported a wide range of costs for HCT, from $36 000 to $88 000 (USD) for a single autologous transplantation for the initial hospitalization, to $200 000 (USD) or more for a myeloablative allogeneic procedure involving an unrelated donor. Common posttransplantation complications, such as infections and GVHD, have been shown to be significant cost drivers. Comparisons across studies are limited by differences in patient populations, cost ascertainment methods, and length of follow-up. This article summarizes the current state of knowledge about costs and cost-effectiveness of HCT, highlighting the challenges in conducting these studies and identifying important areas for future research. We discuss the need for more value-based assessments of HCT using high-quality approaches to measuring costs and outcomes so that potential future efforts to contain costs are well informed and appropriate.

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Section: Why Do Costs Matter?mentioning

confidence: 99%

Economics of hematopoietic cell transplantation

Khera

Zeliadt

Lee

2012

Blood

147

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“…Like with other publications on this issue [13,14], any other costs (inability to work, rehabilitation etc) are not taken into account. Contrary to other publications [13][14][15] which calculate costs retrospectively based on real patient data or from piggy-back studies, this paper attempted to derive costs based on a virtual standard (model) patient. Aspects such as quality of life are likewise not taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

Sensitivity Analysis of Cost Factors for Various Therapy Options in the Treatment of Follicular Lymphoma

Schmitz

Aly²,

Steinmetz³

et al. 2006

Oncol Res Treat

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Background: In Germany, patients with relapsed follicular non-Hodgkin’s lymphoma do not all receive the same treatment. In this study, 3 therapy regimens were analyzed which were considered to be similar. With the goal of determining the treatment option with the lowest direct costs whilst maintaining the same degree of effectiveness, a cost analysis model was established and applied by way of example to the existing illness constellation. Methods: The German doctors’ fee scale (Einheitlicher Bewertungsmaßstab, EBM) valid until 2005 served as the basis for the calculation of medical services within the scope of the present statutory health insurance guidelines. A virtual standard patient was constructed for the cost model and treated with the different therapy regimens. The incidences of individual adverse events described in literature served as the basis for the characterization of the average toxicity of the respective treatment methods. Result: The overall costs result from the sum of the treatment costs and the toxicity-related costs. The effect of additional interventions on the overall cost was also examined. Conclusion: Whereas the accompanying documentation of costs in clinical studies is organizationally complex and very tedious, the model applied here offers a reliable method of quantifying the costs of the different therapy regimens. It permits the comparison of different treatment alternatives, and it enables, by means of a cost variance analysis, the identification of cost drivers and less expensive measures within a therapy method.

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“…[13] In the Netherlands, data collected from patients treated at hospitals indicated that to a Dutch hospital, SCT is the most expensive treatment, and classical chemotherapies and radiotherapy the least expensive, with fludarabine and rituximab in the middle. [4] Across many patient types and costing perspectives, which include the Dutch hospital (treating patients at all ages and times since diagnosis) and a US hospital (treating older, newly diagnosed patients), as well as a US payer (treating hypothetical patients), fludarabine and rituximab appear to offer similar overall costs once higher resource use with fludarabine complications are taken into account. [4,8,9] However, oral formulations of fludarabine have become available and in the UK were calculated to be less expensive than intravenous fludarabine.…”

Section: Direct Costsmentioning

confidence: 99%

Economic Burden of Follicular Non-Hodgkinʼs Lymphoma

Foster¹,

Miller²,

Boye

et al. 2009

PharmacoEconomics

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Follicular non-Hodgkin's lymphoma (FNHL), a slow-growing cancer of the immune system, constitutes about 15-30% of all incident non-Hodgkin's lymphoma in developed countries. Its incidence is rising worldwide. Patients can live many years, but FNHL is considered incurable. We systematically reviewed the English-language MEDLINE-indexed and non-indexed economic literature published in the past 10 years on FNHL, identifying 23 primary economic studies. The economic burden of FNHL is significant, but available data are generally limited to retrospective considerations of hospital-based direct treatment costs, with little information available regarding societal cost of illness. Most direct cost information originates from the US, with one estimate of $US36 000 for the per-patient incremental cost of FNHL care during the first year following diagnosis. The most studied treatment is rituximab, which may offer similar overall costs to fludarabine considering higher resource use with fludarabine complications. Nearly all cost-effectiveness models identified by this review evaluated rituximab for relapsed/refractory FNHL responding to chemotherapy induction. Rituximab is supported as a cost-effective addition to standard chemotherapy by two models in the UK and one in the US, as maintenance therapy instead of stem-cell transplant by one UK model, and as maintenance therapy instead of observation alone by one model each in France, Spain and Canada. The UK National Institute for Health and Clinical Excellence updated guidance on rituximab in February 2008, concluding that it is cost effective when added to induction chemotherapy, and when used as maintenance therapy. No studies of per-patient or national indirect costs of illness were identified, with the only study of indirect costs a Canadian survey documenting lost work productivity. Across all study types identified by our review, the most common focus was on the direct costs of rituximab. As new treatments for FNHL come to market, more real-life cost data are imperative to calculate their relative cost effectiveness.

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Pcn22 Costs of Common Treatment Options for Indolent Follicular Non-Hodgkin's Lymphoma

Cited by 8 publications

References 0 publications

Economics of hematopoietic cell transplantation

Economics of hematopoietic cell transplantation

Sensitivity Analysis of Cost Factors for Various Therapy Options in the Treatment of Follicular Lymphoma

Economic Burden of Follicular Non-Hodgkinʼs Lymphoma

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