Treatment patterns, use of resources, and costs of advanced non-small-cell lung cancer patients in Spain: results from a Delphi panel

Isla, Dolores; González-Rojas, Núria; Nieves, Diana; Brosa, Max; Finnern, Henrik W.

doi:10.1007/s12094-011-0683-0

Cited by 29 publications

(38 citation statements)

References 39 publications

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“…Resource utilization and the unit costs employed in the study were obtained from different Spanish sources30–32 and were updated and clinically validated in 2015 by a Spanish panel of clinical experts composed of three oncologists (DI, JDC, and OJ) who are also co-authors of this study (Table 2). Spanish studies from which the cost of AE was obtained are described.…”

Section: Methodsmentioning

confidence: 99%

“…Spanish studies from which the cost of AE was obtained are described. Most of the unit costs of outpatient and in-hospital management of the AE were obtained from the study by Isla et al30 In this study, a two-round Delphi consensus panel of clinical experts was carried out to describe local clinical patterns based on treatment algorithms from SEOM (Spanish Society of Medical Oncology) and ASCO (American Society of Clinical Oncology) treatment guidelines. The panel consisted of 19 oncologists and one hospital pharmacist, who were asked during the first round to define therapeutic pathways for NSCLC by the patients’ performance status, age, and histology; to quantify the use of resources associated with the preparation and administration of anticancer pharmacotherapy; management of AEs associated with anticancer pharmacotherapy; and best supportive care (BSC).…”

Section: Methodsmentioning

confidence: 99%

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Costs of adverse events associated with erlotinib or afatinib in first-line treatment of advanced EGFR-positive non-small cell lung cancer

Isla¹,

Castro²,

Juan³

et al. 2016

CEOR

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ObjectivesEpidermal growth factor receptor–tyrosine kinase inhibitors (EGFR-TKIs) are an established treatment for advanced non-small cell lung cancer (NSCLC) with EGFR mutation. According to published meta-analyses, no significant efficacy differences have been demonstrated between erlotinib and afatinib. However, the incidence of EGFR–TKI-related adverse events (AEs) was lower with erlotinib. This study compares the cost of management of the AEs associated with these two drugs from the perspective of the Spanish National Health System (NHS).MethodsThe frequency of AEs was established from a recently published meta-analysis. In Spain, the daily cost of both drugs can be considered similar; as a result, only the costs of management of the AEs were considered. Costs and resource utilization in the management of the AEs were estimated by a panel of Spanish oncologists and from studies previously carried out in Spain. A probabilistic analysis was performed based on a Monte Carlo simulation.ResultsThe model generated 1,000 simulations. The total cost per patient treated with erlotinib and afatinib was €657.44 and €1,272.15, respectively. With erlotinib, the cost per patient and per AE of grades ≤2 and ≥3 was €550.86 and €106.58, respectively, whereas the cost with afatinib was €980.63 and €291.52, respectively. The reduction in the number of AEs with erlotinib could avoid a mean cost for the NHS of €614.71 (95% CI: €342.57–881.29) per patient.ConclusionIn advanced EGFR mutation-positive NSCLC patients, first-line treatment with erlotinib could reduce health care costs for the NHS, due to a decrease in the AE rate compared with afatinib. In long-term treatments, the avoidance of complications and the lowering of costs associated with the management of AEs are relevant factors that contribute to the sustainability of the health system.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Costs of adverse events associated with erlotinib or afatinib in first-line treatment of advanced EGFR-positive non-small cell lung cancer

Isla¹,

Castro²,

Juan³

et al. 2016

CEOR

Self Cite

View full text Add to dashboard Cite

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“…Araujo et al [19] calculated € 16,112 for a 2-year period of BSC (€ 8,056/year) using a cost-utility model in 2008. In contrast, Isla et al [20] in 2011 applied a Delphi panel and obtained € 3,410 as lifetime cost (median 3.5 months) of BSC in advanced NSCLC in Spain. Navaratam et al [21] performed a database analysis including chart reviews and obtained a figure of $CAN 8,654 as total expenses for 1 period of BSC (median 13.8 weeks).…”

Section: Discussionmentioning

confidence: 99%

Best Supportive Care from the Conservative/Non-Surgical Perspective and Its Costs in the Treatment of Patients with Advanced Medullary Thyroid Cancer: Results of a Delphi Panel

Kreißl

Jacob²,

Führer

et al. 2014

Oncol Res Treat

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Background: Medullary thyroid cancer (MTC) is a rare tumor entity. The contents of best supportive care (BSC) have not been defined in advanced MTC. The objective of this work is to describe the epidemiology, the treatment patterns with respect to symptom management, as well as palliative treatment and associated costs. Method: A Delphi panel with 9 clinical experts experienced in treating MTC was conducted to obtain details on the epidemiology of MTC and to gain insights into the therapeutic options considered for BSC in advanced MTC in Germany. Unit costs were applied to the described resources from the perspective of the German National Healthcare System in 2011. Results: The annual incidence of MTC in Germany was estimated at about 220. 32% of all patients were estimated to have aggressive/symptomatic MTC, with an estimated mean survival of 36.7 months (median: 36 months). The core element of BSC is relief of symptoms to maintain quality of life. The total mean cost of BSC per patient/year was estimated at € 9,248, lifetime cost at € 28,283. Conclusion: There was consistent agreement within the panel on the epidemiology of MTC and on the structure of the provided therapeutic measures for BSC in advanced MTC, also defining the management of symptoms as a crucial goal of treatment.

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“…The estimated annual cost per patient Review Shen, Chien, Geynisman, Smieliauskas & Shih ranged from US$26,000 to US$95,000. Similarly, a study in Spain [17] studied the treatment patterns, resource use and costs associated with advanced non-small-cell lung cancer (NSCLC) patients and included a long list of oral and non-oral anticancer drugs. The estimated lifetime cost for these patients was between e11,301 and e32,754 per patient.…”

Section: Non-drug-specific Studiesmentioning

confidence: 99%

A review of economic impact of targeted oral anticancer medications

Shen¹,

Chien²,

Geynisman³

et al. 2013

Expert Review of Pharmacoeconomics & Outcomes Research

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There has been a rapid increase in the use of targeted oral anticancer medications (OAMs) in the past decade. As OAMs are often expensive, economic consideration play a significant role in the decision to prescribe, receive or cover them. This paper performs a systematic review of costs or budgetary impact of targeted OAMs to better understand their economic impact on the healthcare system, patients as well as payers. We present our review in a summary table that describes the method and main findings, take into account multiple factors, such as country, analytical approach, cost type, study perspective, timeframe, data sources, study population and care setting when we interpret the results from different papers, and discuss the policy and clinical implications. Our review raises a concern regarding the role of sponsorship on findings of economic analyses as the vast majority of pharmaceutical company-sponsored studies reported cost advantages toward the sponsor's drugs.

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Treatment patterns, use of resources, and costs of advanced non-small-cell lung cancer patients in Spain: results from a Delphi panel

Abstract: In the treatment of advanced or metastatic NSCLC, healthcare costs are impacted by line of treatment, patient performance status, type of administration of therapy and adverse event management.

Cited by 29 publications

References 39 publications

Costs of adverse events associated with erlotinib or afatinib in first-line treatment of advanced EGFR-positive non-small cell lung cancer

Costs of adverse events associated with erlotinib or afatinib in first-line treatment of advanced EGFR-positive non-small cell lung cancer

Best Supportive Care from the Conservative/Non-Surgical Perspective and Its Costs in the Treatment of Patients with Advanced Medullary Thyroid Cancer: Results of a Delphi Panel

A review of economic impact of targeted oral anticancer medications

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