Direct Treatment Costs for Patients with Lung Cancer from First Recurrence to Death in France

17081 Background: Neutropenia (N) and febrile neutropenia (FN) are common adverse effects of chemotherapy, resulting in increased risk of infections and hospitalizations. Both conditions account for substantial health resource utilization (HRU). The objective of this study was to evaluate HRU patterns for patients (PTS) experiencing N or FN in “real world” practice and to model the corresponding HRU cost profiles. Methods: Breast and lung cancer PTS receiving granulocyte colony stimulating factor (GCSF) to treat chemotherapy- induced neutropenia (absolute neutrophil count [ANC] =1500 cell/μL) were selected from 8 Portuguese hospitals. In the absence of a comprehensive database PTS having neutropenia were originally identified from hospital pharmacies GCSF prescription lists; afterwards, HRU frequency (hospitalization, clinical visits, complementary examinations, medication, transfusions) in relation to N or FN (ANC =1000 cell/μL and body temperature= 38.5°C over one hour) was reviewed retrospectively from clinical records. Treatment costs attributed to N/FN were calculated by multiplying HRU frequency by unit costs from the Portuguese Ministry of Health costs database. To account for the skewed nature of the data costs were modelled using generalized linear models with gamma distribution and log link. Results: The study included 50 PTS with breast cancer and 48 with lung cancer. Mean (SD) age was 60.0 (12.5) years and 61.2% were women. Mean (SD) ANC at first N was 724 (433) cell/μL. FN (mean (SD) ANC 440 (370) cell/μL) was developed by 16.5% of PTS. Mean (SD) total cost of N treatment was 922 (1162) € (28% hospitalization, 5% clinical visits, 3% complementary examinations, 54% medication, 10% transfusions). Controlling for PTS clinical and sociodemographic characteristics, total treatment cost were 3.2 (95%CI:1.9–5.2) times higher for PTS with FN (p<0.001) when compared to N PTS, 4.4% (95%CI: 0.1–7.7) greater for every 100 cell/μL decrease in ANC (p=0.03) and 2.5% (95%CI: 1.0–4.1) higher per additional year of age at N or FN diagnosis (p=0.002). Conclusions: Chemotherapy-induced neutropenia direct treatment costs were substantially incremented in febrile patients. [Table: see text]

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Epidemiology and Treatment Costs of Bone Metastases from Lung Cancer: A French Prospective, Observational, Multicenter Study (GFPC 0601)

Journal of Thoracic Oncology ◽

10.1097/jto.0b013e318206a1e3 ◽

2011 ◽

Vol 6 (3) ◽

pp. 576-582 ◽

Cited By ~ 70

Author(s):

Chantal Decroisette ◽

Isabelle Monnet ◽

Henri Berard ◽

Gilles Quere ◽

Herve Le Caer ◽

...

Keyword(s):

Lung Cancer ◽

Bone Metastases ◽

Multicenter Study ◽

Treatment Costs

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The Daily Living Programme

The British Journal of Psychiatry ◽

10.1192/bjp.160.3.379 ◽

1992 ◽

Vol 160 (3) ◽

pp. 379-384 ◽

Cited By ~ 79

Author(s):

M. Muijen ◽

I. M. Marks ◽

J. Connolly ◽

B. Audini ◽

G. McNamee

Keyword(s):

Mental Illness ◽

Home Care ◽

Serious Mental Illness ◽

Daily Living ◽

Hospital Care ◽

Treatment Costs ◽

Standard Group ◽

Direct Treatment ◽

Individualised Treatment ◽

Hospital Use

Patients with a serious mental illness requiring admission were randomised to home care or standard hospital care. Over the initial 18 months, 60 patients entered each group and were studied for a mean of 10 months. Home care reduced hospital use by 80%, with patients being admitted for a mean of 14 days, compared with 72 days for the standard group, but this bed-saving made no difference in direct treatment costs. Home care offers individualised treatment, and many patients require continuing support with the emphasis on areas such as finances and housing.

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Lung Cancer–Related Clinical and Economic Impacts of Achieving a 5% Smoking Prevalence Rate by 2035 in Canada

Journal of Global Oncology ◽

10.1200/jgo.18.27500 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 28s-28s

Author(s):

C. Gauvreau ◽

N. Fitzgerald ◽

S. Hussain ◽

S. Memon ◽

W. Flanagan ◽

...

Keyword(s):

Lung Cancer ◽

Prevalence Rate ◽

Smoking Prevalence ◽

Economic Impacts ◽

Treatment Costs ◽

Reference Scenario ◽

Smoking Rate ◽

Life Years ◽

The Impact ◽

Smoking Prevalence Rate

Background: Smoking is responsible for nearly 85% of lung cancer cases and 30% of all cancer-related deaths. Canada has set an ambitious target to reduce tobacco use to 5% by 2035 in alignment with a world-wide tobacco endgame initiative. Aim: We project the impact of achieving a national 5% smoking prevalence rate by 2035 on population-level lung cancer outcomes and costs. Methods: OncoSim-Lung (version 2.5), led by the Canadian Partnership Against Cancer with model development by Statistics Canada, is a microsimulation model that incorporates Canadian demographics, risk factors, registry data, resource utilization and other data to project clinical and economic impacts of cancer control measures. Smoking cessation parameters were modified to reduce the current average national smoking prevalence rate of 18% over time to 5% in 2035. Impacts were compared with those in a reference scenario, which maintained the current prevalence rate. Outputs of interest included lung cancer incidence, mortality, treatment costs, and quality-adjusted life-years (QALYs). Costs and QALYs are undiscounted and reported in 2016 CAD. Results: Achieving a 5% smoking rate by 2035 would result in a 2017-2035 cumulative total of 31,000 fewer lung cancer cases, 21,000 fewer lung cancer-related deaths, and 457,000 additional QALYs compared with projections based on a constant smoking prevalence rate of ∼20%. When stratified by sex, there would be 15,600 and 15,700 fewer lung cancer diagnoses and 11,000 and 10,000 fewer lung cancer-related deaths for males and females respectively. Furthermore, treatment-related costs would be reduced by $680 million dollars. On average there would be 4,500 fewer lung cancer cases, 3,500 fewer deaths, and $35 million in cost savings annually. If a 5% smoking rate is sustained until 2050, then there would be a 15% reduction in lung cancer cases and a 13% reduction in deaths from 2017-2050. Conclusion: Reducing Canada's smoking prevalence to 5% by 2035 could result in a significant reduction in lung cancer cases, deaths and treatment costs. Like Canada, other countries with relatively high smoking prevalence could use averted treatment costs to offset costs of aggressive smoking prevention and cessation programs or redirect them to other healthcare services.

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Predictive scoring systems for brain metastasis at diagnosis and at recurrence in non-small cell lung cancer

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e19020 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e19020-e19020

Author(s):

S. T. Maunglay ◽

W. J. Fulp ◽

A. Chiappori ◽

G. R. Simon

Keyword(s):

Lung Cancer ◽

Multivariate Analysis ◽

Brain Metastasis ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Scoring System ◽

Scoring Systems ◽

Small Cell ◽

Small Cell Lung ◽

First Recurrence

e19020 Background: Brain metastasis (BM) is a major cause of mortality and morbidity in Non Small Cell Lung Cancer (NSCLC) but large studies analyzing potential factors that could be predictive of BM at diagnosis or recurrence are lacking. We have developed 2 predictive scoring models to identify the patients at risk. Methods: A retrospective analysis on 4,294 NSCLC cases, seen between 1994 and 2006, at the Moffitt Cancer Center and Research Institute, Tampa, FL was performed utilizing the cancer center's registry data. 477 (11.12%) patients had BM at the time diagnosis and additional 252 (5.82%) patients developed new BM as first recurrence. Results: For patients with BM at diagnosis, age younger than 63 years, non squamous histology and current or never smoking status were all significant in both univariate and multivariate analysis (N= 4174). Based on calculated odds ratios, a scoring system of 0 to 6 points was developed for these patients. Higher scores predicted higher risk for BM (0- 2=3.38%, 3- 4=9.93%, 5=13.65% and 6=21.03%; p <.0001). For patients with new BM at first recurrence, age younger than 63 years, non squamous histology, and the stage at diagnosis (i.e., BM risk in stage III>IV>II>I), were all significant in both univariate and multivariate analysis (N=4291). Based on calculated odds ratios, a scoring system of 0 to 7 points was developed for these patients. Higher scores predicted higher risk for BM (0–1=3.38%, 2–3=4.72%, 4–5= 8.76%, and 6–7=11.83%; p<.0001). Similar risk percentage results were seen after testing the 2 scoring systems in 3 chronologically divided patient groups. Conclusions: The 2 scoring systems developed based only on clinical data were predictive of BM in NSCLC at diagnosis and recurrence. These scoring systems should be helpful for establishing initial and follow up cranial imaging schedules in NSCLC patients. [Table: see text] No significant financial relationships to disclose.

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PDB27 INSULIN GLARGINE AND NPH INSULIN-BASED REGIMENS REVEAL COMPARABLE TOTAL DIRECT TREATMENT COSTS IN TYPE 2 DIABETES PATIENTS.THE LONG-ACTING INSULIN GLARGINE VS. NPH INSULIN COST EVALUATION STUDY IN GERMANY (LIVE-DE)

Value in Health ◽

10.1016/s1098-3015(10)66675-2 ◽

2008 ◽

Vol 11 (6) ◽

pp. A504

Author(s):

T Scholten ◽

R Holle ◽

W Landgraf ◽

A Spiesecke ◽

H Hauner

Keyword(s):

Type 2 Diabetes ◽

Insulin Glargine ◽

Evaluation Study ◽

Treatment Costs ◽

Cost Evaluation ◽

Nph Insulin ◽

Direct Treatment ◽

Acting Insulin ◽

Long Acting

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The cost of players’ injuries to professional sports leagues and other sports organizations

Managerial Finance ◽

10.1108/mf-06-2020-0301 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Bhavneet Walia ◽

Christopher John Boudreaux

Keyword(s):

Primary Source ◽

Professional Sports ◽

Treatment Costs ◽

Content Type ◽

Sports Organizations ◽

Direct Treatment ◽

Sports Leagues ◽

Playing Time ◽

The Cost ◽

Professional Sports Leagues

PurposeMost literature studies have focused on direct treatment costs of injuries. This literature is extended to include the foregone playing time of players as an additional injury cost.Design/methodology/approachThe authors have reviewed the literature on the cost of players’ injuries to professional sports leagues and other organizations.FindingsThe authors concluded that players’ injury costs are substantial and sufficiently variable to be a primary source of financial uncertainty for a team.Originality/valueThis study's value has added risk pooling and league-wide revenue sharing as tools to mitigate the risk of injury costs. Previous literature reviews focused predominately on direct treatment costs.

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