scholarly journals Real-World Assessment of Health Care Costs for Patients with Metastatic Pancreatic Cancer Following Initiation of First-Line Chemotherapy

2020 ◽  
Vol 26 (7) ◽  
pp. 872-878
Author(s):  
Andrea Bullock ◽  
Christopher G. Rowan ◽  
Nina Oestreicher ◽  
Homa Yeganegi ◽  
E. Gabriela Chiorean
Keyword(s):  
Health Care ◽  
Pancreatic Cancer ◽  
Health Care Costs ◽  
Real World ◽  
Metastatic Pancreatic Cancer ◽  
First Line ◽  
Care Costs ◽  
Line Chemotherapy

scholarly journals Treatment Patterns and Health Care Costs in Commercially Insured Patients with Follicular Lymphoma

2020 ◽  
Vol 7 (2) ◽  
pp. 265-276
Author(s):  
Nathan Fowler ◽  
Guifang Chen ◽  
Stephen Lim ◽  
Stephanie Manson ◽  
Qiufei Ma ◽  
...  
Keyword(s):  
Health Care ◽  
Follicular Lymphoma ◽  
Health Care Costs ◽  
Real World ◽  
Economic Burden ◽  
Second Line ◽  
First Line ◽  
Line Therapy ◽  
Line Of Therapy ◽  
Care Costs

Background: Few studies have estimated the real-world economic burden such as all-cause and follicular lymphoma-related costs and health care resource utilization (HCRU) in patients with follicular lymphoma (FL). Objectives: This study evaluated outcomes in patients who were newly initiated with FL indicated regimens by line of therapy with real-world data. Methods: A retrospective study was conducted among patients with FL from MarketScan® databases between January 1, 2010 and December 31, 2013. Patients were selected if they were ≥18 years old when initiated on a FL indicated therapy, had at least 1 FL-related diagnosis, ≥1 FL commonly prescribed systemic anti-cancer therapy after diagnosis, and did not use any FL indicated regimen in the 24 months prior to the first agent. These patients were followed up at least 48 months and the outcomes, including the distribution of regimens by line of therapy, the treatment duration by line of therapy, all-cause and FL-related costs, and HCRU by line of therapy were evaluated. Results: This study identified 598 patients who initiated FL indicated treatment. The average follow-up time was approximately 5.7 years. Of these patients, 50.2% (n=300) were female, with a mean age of 60.7 years (SD=13.1 years) when initiating their treatment with FL indicated regimens. Overall, 598 (100%) patients received first-line therapy, 180 (43.6%) received second-line therapy, 51 received third-line therapy, 21 received fourth-line therapy, and 10 received fifth-line therapy. Duration of treatment by each line of therapy was 370 days, 392 days, 162 days, 148 days, and 88 days, respectively. The most common first-line regimens received by patients were rituximab (n=201, 33.6%), R-CHOP (combination of rituximab, cyclophosphamide, doxorubicin hydrochloride [hydroxydaunomycin]; n=143, 24.0%), BR (combination of bendamustine and rituximab; n=143, 24.0%), and R-CVP (combination of rituximab, cyclophosphamide, vincristine, and prednisone; n=71, 11.9%). The most common second-line treatment regimens were (N=180): rituximab (n=78, 43.3%) and BR (n=41, 22.8%). Annualized all-cause health care costs per patient ranged from US$97 141 (SD: US$144 730) for first-line to US$424 758 (SD: US$715 028) for fifth-line therapy. Conclusions: The primary regimens used across treatment lines conform to those recommended by the National Comprehensive Cancer Network clinical practice guidelines. The economic burden for patients with FL is high and grows with subsequent lines of therapy.

scholarly journals Cost-Effectiveness Analysis of Brentuximab Vedotin With Chemotherapy in Newly Diagnosed Stage III and IV Hodgkin Lymphoma

2018 ◽  
Vol 36 (33) ◽  
pp. 3307-3314 ◽  
Author(s):  
Scott F. Huntington ◽  
Gottfried von Keudell ◽  
Amy J. Davidoff ◽  
Cary P. Gross ◽  
Sapna A. Prasad
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Costs ◽  
Brentuximab Vedotin ◽  
Stage Iii ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Line Setting ◽  
Care Costs

Purpose In a recent randomized, open-label trial (ECHELON-1), brentuximab vedotin (BV) combined with doxorubicin, vinblastine, and dacarbazine (AVD+BV) decreased the risk of progression in adults diagnosed with stage III or IV Hodgkin lymphoma (HL) compared with standard bleomycin-containing chemotherapy (doxorubicin, bleomycin, vinblastine, and dacarbazine [ABVD]). However, the cost effectiveness of incorporating BV (US$6,970 per 50-mg vial) into the first-line setting is unknown. Patients and Methods We constructed a Markov decision-analytic model to measure the costs and clinical outcomes for AVD+BV compared with ABVD as first-line therapy in a cohort of patients with stage III or IV HL. Transition probabilities were estimated from ECHELON-1 by fitting parametric survival distributions. Lifetime direct health care costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated for AVD+BV compared with ABVD from a US payer perspective. Our model was also used to estimate BV price reductions that would achieve more favorable cost effectiveness under indication-specific pricing. Results AVD+BV was associated with an improvement of 0.56 QALYs compared with treatment with standard ABVD. However, incorporating BV into first-line therapy led to significantly higher lifetime health care costs ($361,137 v $184,291), causing the ICER for AVD+BV to be $317,254 per QALY. If indication-specific pricing were implemented, acquisition costs for BV used in the first-line setting would need to be reduced by 56% to 73% for ICERs of $150,000 to $100,000 per QALY, respectively. Conclusion Substituting BV for bleomycin during first-line therapy for stage III or IV HL is unlikely to be cost effective under current drug pricing. Should indication-specific pricing be implemented, significant price reductions for BV used in the first-line setting would be needed to reduce ICERs to more widely acceptable values.

scholarly journals Analysis of real-world health care costs among immunocompetent patients aged 50 years or older with herpes zoster in the United States

2017 ◽  
Vol 13 (8) ◽  
pp. 1861-1872 ◽  
Author(s):  
Juliana L. Meyers ◽  
Shweta Madhwani ◽  
Debora Rausch ◽  
Sean D. Candrilli ◽  
Girishanthy Krishnarajah ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Herpes Zoster ◽  
Health Care Costs ◽  
Real World ◽  
The United States ◽  
World Health ◽  
Care Costs ◽  
Immunocompetent Patients

Is it cost-effective to add erlotinib to gemcitabine in advanced pancreatic cancer?

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6048-6048 ◽  
Author(s):  
S. S. Grubbs ◽  
P. A. Grusenmeyer ◽  
N. J. Petrelli ◽  
R. J. Gralla
Keyword(s):  
Health Care ◽  
Pancreatic Cancer ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Health Care Costs ◽  
Advanced Pancreatic Cancer ◽  
Cost Effective ◽  
Significant Difference ◽  
The Impact ◽  
Care Costs

6048 Background: Single agent gemcitabine has been considered the standard of care in advanced pancreatic cancer since 1996. A recent 569 patient randomized trial comparing gemcitabine alone with gemcitabine + erlotinib as first line therapy found a small but statistically significant difference in survival (6.0 vs 6.4 months, respectively, p = .028). The impact on survival may be small, but with nearly 33,000 new cases of pancreatic cancer per year, the impact on health care costs with the use of the combined regimen may be large. Using the known survival data and costs, we analyzed the incremental cost-effectiveness of adding erlotinib. Methods: Costs for a six month course of gemcitabine were developed using Medicare reimbursement from the January, 2006 CMS Drug Payment Table and Physician Fee Schedule assuming no change in infusion reimbursement. Since erlotinib is not approved as a Medicare Part B drug, costs were developed from wholesale and retail sources. Drug dosing and schedules were based on the clinical trial protocol leading to approval. Incremental cost effectiveness of adding erlotinib was calculated. Results: Six month course of gemcitabine alone costs $23,493. The addition of erlotinib increases cost by $12,156 wholesale or $16,613 retail. Given an increase of 0.4 months in median survival over gemcitabine alone, the addition of erlotinib costs $364,680 per year of life gained (YLG) wholesale and $498,379/YLG retail. Sensitivity analyses were conducted assuming shorter therapy of 4 and 5 months. In order to be cost effective even at the $100,000/YLG level, six months of erlotinib would have to be reduced to 20% of the current retail cost (lowered to $18.52 per tablet.) Conclusions: Adding erlotinib to gemcitabine does not approach cost effectiveness at even the highest year per life gained parameters. Such impacts on health care costs, especially for very small gains, become more pressing as all health care costs continue to increase. [Table: see text] [Table: see text]

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