The impact of recent chemotherapy innovation on the longevity of myeloma patients: US and international evidence

Hostenkamp, Gisela; Lichtenberg, Frank R.

doi:10.1016/j.socscimed.2015.02.003

Cited by 13 publications

(7 citation statements)

References 22 publications

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“…Although this severe disease remains incurable, it has become increasingly treatable. The availability of novel agents currently used by oncologists, including immunomodulatory drugs (thalidomide and lenalidomide) and proteasome inhibitors (bortezomib) as single agent or in combination regimens, has significantly improved the longevity of patients with newly diagnosed and relapsed/refractory MM . However, these recent innovations also have resulted in increasing costs.…”

Section: What Is Known and Objectivementioning

confidence: 99%

“…The availability of novel agents currently used by oncologists, including immunomodulatory drugs (thalidomide and lenalidomide) and proteasome inhibitors (bortezomib) as single agent or in combination regimens, has significantly improved the longevity of patients with newly diagnosed and relapsed/refractory MM. 3 However, these recent innovations also have resulted in increasing costs. In view of the limited availability of healthcare resources, economic evaluations have become an important tool, helping policymakers efficiently allocate resources in many countries.…”

Section: What Is Known and Objectivementioning

confidence: 99%

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Systematic review of the economic evaluations of novel therapeutic agents in multiple myeloma: what is the reporting quality?

2016

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Summary What is known and objective Given the increasing healthcare costs and the recent introduction of novel agents in the treatment for multiple myeloma (MM), an incurable haematologic malignancy, more efficient use of existing resources is fundamental. The objective of this study was to systematically review economic evaluations of the use of novel agents in MM and assess their reporting quality. Methods A literature search was performed in PubMed/Medline, Latin American and Caribbean Health Sciences Literature, Cost‐Effectiveness Analysis Registry and the National Health Services Economic Evaluation Database for economic evaluations up to June 2015. The search strategy included Medical Subject Headings terms or text words related to MM, economic evaluations and drugs. Full economic evaluations of bortezomib, thalidomide or lenalidomide in patients with MM that were published in English, Portuguese or Spanish were included. Two independent authors performed study selection, data extraction and quality assessment using 24 items from the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Results and discussion Of the 132 potentially relevant records identified, eight satisfied the inclusion criteria. Most studies were cost‐effectiveness analyses combined with cost‐utility analyses (n = 6) from the public payer perspective (n = 4) and were performed in Europe (n = 6) on patients with refractory or relapsed MM (n = 5). All studies were based on economic models, with four of them using discrete event simulation. We found bortezomib‐based therapies to be one of the more commonly selected treatment strategies for comparison (n = 7). Overall, the intervention was more effective and costlier than the alternative strategy (average of $54 630 per life year; $68 261 per quality‐adjusted life year–QALY). The CHEERS’ total score was 14·6 (SD = 2·6) with the most frequent problems being the lack of precision measures for all model parameters, no evaluation of heterogeneity of the results by subgroup analyses and no description of the role the funder in the identification, design, conduct and reporting of the analysis. What is new and conclusion Most analyses of the novel therapeutic agents determined that they were cost‐effective in MM at a threshold of up to $100 000/QALY. Nevertheless, the poor reporting quality of the economic studies requires improvement to ensure greater transparency.

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Section: What Is Known and Objectivementioning

confidence: 99%

Section: What Is Known and Objectivementioning

confidence: 99%

Systematic review of the economic evaluations of novel therapeutic agents in multiple myeloma: what is the reporting quality?

2016

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“…33 Access to new drugs, including anti-hypertensives and statins, has been demonstrated in Canada and several other countries to have a beneficial impact on health outcomes that outweigh the increased cost. [34][35][36][37][38] The limited access to anti-hypertensives in New Zealand is surprising because hypertension is "a worldwide problem of enormous consequence." 39 The PHARMAC system has contained costs in New Zealand, but it restricts or denies access to important new medicines with the potential to improve patients' lives.…”

Section: Discussionmentioning

confidence: 99%

Leading causes of mortality and prescription drug coverage in Canada and New Zealand

Rawson¹

2020

Preprint

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Background: Canada may soon see the introduction of a national pharmaceutical insurance system. New Zealand has a government-funded healthcare system used by all residents that operates within a tight cost-containment budget. Objective: To compare the main mortality causes in Canada and New Zealand and examine listings in current Canadian provincial public drug plans and the New Zealand national drug formulary. Methods: Age-standardized mortality rates from 1985 to 2014 and data on hospital discharges and average length of stay in hospital for Canada and New Zealand were obtained from the Organization for Economic Cooperation and Development's website. Information on insured medications was obtained from Canadian provincial drug plan lists and the New Zealand Pharmaceutical Schedule current in mid-2019. Results: Mortality rates for acute myocardial infarction, ischemic heart disease and cerebrovascular disease were higher, on average over the 30-year observation period, in New Zealand, but rates for malignancies and respiratory disorders were similar in the two countries. Reimbursement listing rates for drugs for cancer and some cardiovascular indications were lower in New Zealand than in Canada. Conclusions: New Zealand's drug coverage system has contained costs, but it restricts or denies access to new innovative medicines with the potential to improve patients' lives. Although a New Zealand-style national pharmacare scheme in Canada would offer the opportunity to restrain drug expenditure, it would likely fail to satisfy patients and healthcare providers and diminish health outcomes, resulting in higher costs in other healthcare sectors.

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“…Further complicating treatment goals are the continually rising costs associated with cancer care, which are outpacing other types of healthcare costs 2,3. A variety of factors are driving the budgetary impact of cancer care, including increasing incidence with a growing and aging population,4,5 a shift toward more costly personalized care,4 increased cancer survivorship,5–7 and increasing availability and adoption of new branded therapies 8,9…”

Section: Introductionmentioning

confidence: 99%

<p>Relative value assessment: characterizing the benefit of oncology therapies through diverse survival metrics from a US perspective</p>

Macaulay¹,

Ahuja²,

Ademisoye³

et al. 2019

CEOR

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ObjectivesThe introduction of innovative, high-cost oncology treatments, coupled with mounting budgetary pressures, necessitates value trade-offs across cancer types. Defining value is critical to informing decision-making. A cost-value analysis tool was used to assess relative clinical value from a US perspective using multiple outcome metrics for a variety of metastatic cancers.MethodsLiterature published (January 1, 2000–August 31, 2016) was reviewed to identify outcome metrics for approved treatments for metastatic cancers. Data were extracted or derived for median and mean overall survival (OS), landmark survival rates, and other survival metrics, and compared across treatments vs their respective trial comparators, with and without considering costs.ResultsReported survival metrics varied by agent within cancer type. For treatment of prostate cancer, abiraterone yielded the highest improvement in 1-year survival rate (13.7%, previously treated), whereas enzalutamide yielded the highest median OS improvement (4.8 months, previously treated) and sipuleucel-T, the highest mean OS improvement (3.6 months, previously untreated) vs their respective trial comparators. For treatment of non-small cell lung cancer vs their respective trial comparators, nivolumab yielded the highest improvement in mean OS (11.9 months) and 3-year survival rate (12.6%), each in previously treated squamous disease, whereas afatinib yielded the highest median OS improvement (4.1 months, previously untreated EGFR del19 and L858R mutants). Cost-value analysis results varied with the applied survival metric.ConclusionsAlthough median OS is the traditional gold standard oncology efficacy metric, it fails to capture long-term survival benefits—the ultimate goal of cancer treatment—offered by new treatment modalities. Diverse metrics are needed for comprehensive value assessments of cancer therapies.

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The impact of recent chemotherapy innovation on the longevity of myeloma patients: US and international evidence

Cited by 13 publications

References 22 publications

Systematic review of the economic evaluations of novel therapeutic agents in multiple myeloma: what is the reporting quality?

Systematic review of the economic evaluations of novel therapeutic agents in multiple myeloma: what is the reporting quality?

Leading causes of mortality and prescription drug coverage in Canada and New Zealand

<p>Relative value assessment: characterizing the benefit of oncology therapies through diverse survival metrics from a US perspective</p>

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