Cost of Venous Thromboembolic Disease in Patients with Lung Cancer: Costecat Study

Background: Patients with lung cancer (LC) are at significantly higher risk of developing venous thromboembolism (VTE), which may lead to increased use of health resources and the cost of management. The main aim of the study was to determine the cost of the management of VTE events in patients with LC treated with Low Molecular Weight Heparins (LMWH) in Spain. Methods: Costecat was an, observational, ambispective pharmacoeconomic study. Patients with LC, with a first episode of VTE (symptomatic or incidental) in treatment with LMWH, were recruited from six third-level hospitals and followed up for six months. Sociodemographic, clinical and resource use variables of VTE-related implications and its treatment were collected. Direct healthcare costs and direct non-healthcare costs were recorded. Data collection was documented in an electronic case report. Unit costs were obtained from national databases. Costs (€2018) were estimated from the healthcare perspective. Statistical analysis was performed using the statistical program R 3.4.3 version (30 November 2017). Results: Forty-seven patients were included. Mean age was 65.4 years, 66.0% were male. The percentage of patients with LC who had metastatic disease was 78.7%. Twenty-three patients (48.9%) needed hospital admissions due to thromboembolic episode. Total average cost of patients with cancer associated VTE (CAT) was €109,696.6 per patient/semester. The hospitalizations represent 65.8% of total costs (7207.3 € SD 13,996.9 €), followed by LMWH therapy which represents 18.6% (2033.8 € SD:630.5 €). Conclusions: Venous thromboembolism episodes induce an economic impact on patients and healthcare systems. Direct healthcare costs are the major burden of the total cost, in which hospitalizations are the main drivers of cost.

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Direct healthcare costs of lip, oral cavity and oropharyngeal cancer in Brazil

PLoS ONE ◽

10.1371/journal.pone.0246475 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246475

Author(s):

Vanessa Milani ◽

Ana Laura de Sene Amâncio Zara ◽

Everton Nunes da Silva ◽

Larissa Barbosa Cardoso ◽

Maria Paula Curado ◽

...

Keyword(s):

Healthcare Costs ◽

Health Sector ◽

National Health System ◽

Health Resources ◽

Indirect Costs ◽

International Classification Of Diseases ◽

Outpatient Procedures ◽

Classification Of Diseases ◽

Direct Healthcare Costs ◽

The Cost

The efficiency of public policies includes the measurement of the health resources used and their associated costs. There is a lack of studies evaluating the economic impact of oral cancer (OC). This study aims to estimate the healthcare costs of OC in Brazil from 2008 to 2016. This is a partial economic evaluation using the gross costing top-down method, considering the direct healthcare costs related to outpatients, inpatients, intensive care units, and the number of procedures, from the perspective of the public health sector. The data were extracted from the Outpatient and Inpatient Information System of the National Health System, by diagnosis according to the 10th Revision of the International Classification of Diseases, according to sites of interest: C00 to C06, C09 and C10. The values were adjusted for annual accumulated inflation and expressed in 2018 I$ (1 I$ = R$2,044). Expenditure on OC healthcare in Brazil was I$495.6 million, which was composed of 50.8% (I$251.6 million) outpatient and 49.2% (I$244.0 million) inpatient healthcare. About 177,317 admissions and 6,224,236 outpatient procedures were registered. Chemotherapy and radiotherapy comprised the largest number of procedures (88.8%) and costs (94.9%). Most of the costs were spent on people over 50 years old (72.9%) and on males (75.6%). Direct healthcare costs in Brazil for OC are substantial. Outpatient procedures were responsible for the highest total cost; however, inpatient procedures had a higher cost per procedure. Men over 50 years old consumed most of the cost and procedures for OC. The oropharynx and tongue were the sites with the highest expenditure. Further studies are needed to investigate the cost per individual, as well as direct non-medical and indirect costs of OC.

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PCN76 Evaluating Trends In Direct Healthcare Costs In The Last Year Of Life Among Patients With Lung Cancer In Germany

Value in Health ◽

10.1016/j.jval.2020.08.213 ◽

2020 ◽

Vol 23 ◽

pp. S435

Author(s):

R. Knapp ◽

F. Hardtstock ◽

U. Maywald ◽

T. Wilke

Keyword(s):

Lung Cancer ◽

Healthcare Costs ◽

Direct Healthcare Costs

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Direct healthcare costs of sedentary behaviour in the UK

Journal of Epidemiology & Community Health ◽

10.1136/jech-2018-211758 ◽

2019 ◽

Vol 73 (7) ◽

pp. 625-629 ◽

Cited By ~ 13

Author(s):

Leonie Heron ◽

Ciaran O'Neill ◽

Helen McAneney ◽

Frank Kee ◽

Mark A Tully

Keyword(s):

Public Health ◽

Lung Cancer ◽

Type 2 Diabetes ◽

Sedentary Behaviour ◽

Healthcare Costs ◽

Double Counting ◽

All Cause Mortality ◽

Direct Healthcare Costs ◽

The Uk

BackgroundGrowing evidence indicates that prolonged sedentary behaviour increases the risk of several chronic health conditions and all-cause mortality. Sedentary behaviour is prevalent among adults in the UK. Quantifying the costs associated with sedentary behaviour is an important step in the development of public health policy.MethodsNational Health Service (NHS) costs associated with prolonged sedentary behaviour (≥6 hours/day) were estimated over a 1-year period in 2016–2017 costs. We calculated a population attributable fraction (PAF) for five health outcomes (type 2 diabetes, cardiovascular disease [CVD], colon cancer, endometrial cancer and lung cancer). Adjustments were made for potential double-counting due to comorbidities. We also calculated the avoidable deaths due to prolonged sedentary behaviour using the PAF for all-cause mortality.ResultsThe total NHS costs attributable to prolonged sedentary behaviour in the UK in 2016–2017 were £0.8 billion, which included expenditure on CVD (£424 million), type 2 diabetes (£281 million), colon cancer (£30 million), lung cancer (£19 million) and endometrial cancer (£7 million). After adjustment for potential double-counting, the estimated total was £0.7 billion. If prolonged sedentary behaviour was eliminated, 69 276 UK deaths might have been avoided in 2016.ConclusionsIn this conservative estimate of direct healthcare costs, prolonged sedentary behaviour causes a considerable burden to the NHS in the UK. This estimate may be used by decision makers when prioritising healthcare resources and investing in preventative public health programmes.

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731 Costs of care for first-line (1L) treatment of advanced non-small cell lung cancer (aNSCLC): a real-world claims analysis

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-sitc2020.0731 ◽

2020 ◽

Vol 8 (Suppl 3) ◽

pp. A775-A775

Author(s):

Jonathan Kish ◽

Dhruv Chopra ◽

Djibril Liassou ◽

Solomon Lubinga ◽

John Hartman ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Healthcare Costs ◽

Healthcare Resource Utilization ◽

Small Cell ◽

Small Cell Lung ◽

Icd 10 ◽

Direct Healthcare Costs ◽

Comorbidity Index

BackgroundRecent advances in therapy have created numerous options for the 1L treatment of aNSCLC. This study describes the total direct healthcare costs for patients treated with immunotherapy monotherapy (IO), chemotherapy (CT), or immunotherapy plus chemotherapy (IO+CT) in the 1L setting.MethodsThe Ability Patient Complete claims database was used to identify US patients aged ≥ 18 years diagnosed with aNSCLC (ICD-9: 162.*; ICD-10: C34.*) initiating 1L treatment with IO, CT, or IO+CT between January 2015 and May 2019. Patients were required to have at least 6 months of continuous enrollment prior to initiation of 1L treatment, ≥ 1 inpatient or 2 outpatient claims for lung cancer, and a claim within 45 days for a secondary metastatic site. Patients with another malignant primary cancer, who participated in a clinical trial, or who received treatments consistent with small cell lung cancer or a systemic therapy not used for lung cancer were excluded. Costs were calculated on a per-patient per month (PPPM) basis from initiation of 1L treatment until discontinuation or end of study period and expressed in 2019 US dollars. A standardized cost approach was applied, with average wholesale prices for antineoplastic and other drug costs and CMS fee schedules for outpatient visits, inpatient stays, ED visits, and other medical costs (e.g. all other outpatient medical services including infusions of growth factors, radiographic studies, blood draws, etc.). All antineoplastic costs were considered individually.Results8,154 patients were included in the cohort: 1,319 received IO, 5,315 CT, and 1,520 IO+CT. By cohort, mean age was 65 (IO), 63 (CT), and 62 (IO+CT) years while mean Charlson Comorbidity Index was 2.12, 2.11, and 1.83, respectively. Key results by healthcare resource utilization category are provided in the table below (table 1).Abstract 731 Table 1Mean PPPM Costs of 1L aNSCLC TreatmentsConclusionsThe total PPPM healthcare costs of patients receiving chemotherapy (CT or IO+CT) are higher than those only receiving IO monotherapy. These differences are driven by higher outpatient visit, other medical, and pharmacy costs. IO-containing regimens have higher antineoplastic costs than CT, but options with no or limited CT may be able to offset these costs through a reduction in other medical expenses.

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Risk Stratification of Recurrent Venous Thromboembolism.

Blood ◽

10.1182/blood.v114.22.2981.2981 ◽

2009 ◽

Vol 114 (22) ◽

pp. 2981-2981

Author(s):

Rainer B. Zotz ◽

Andrea Gerhardt

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Risk Stratification ◽

Conflicts Of Interest ◽

Oral Anticoagulant Therapy ◽

Venous Thromboembolic Event ◽

First Episode ◽

Recurrent Venous Thromboembolism ◽

Yearly Incidence ◽

Venous Thromboembolic

Abstract Abstract 2981 Poster Board II-956 Background: A better risk stratification for recurrent venous thromboembolism (VTE) in patients with a first episode of idiopathic venous thromboembolism (VTE) is urgently needed. Methods: Retrospective study covering more than 20 years after a first venous thromboembolic event in a group of 1,440 patients with VTE. Results: In the subgroup of patients (n=515) with a first spontaneous VTE, the yearly incidence of a recurrent spontaneous VTE was 8% for the time period 0-2 years and 4-6% in the following 8 years, after a first VTE, triggered by a transient risk factor (oral contraceptives, surgery or immobilization, pregnancy), the yearly incidence of a recurrent spontaneous VTE was 2% (first 2 years) and 1.3-3% (following 8 years). The hazard ratio for recurrent spontaneous VTE in patients with a first spontaneous VTE for specific predictors were as follows: prothrombin mutation heterozygous 1.2 (95% CI 0.9-1.7), FVL heterozygous 1.3 (95% CI 0.92-1.8), male sex 1.9 (95% CI 1.4-2.7), D-Dimer 2.3 (0.9-6.4), protein C (<60% activity) 2.6 (95% CI 1.2-5.7), FVL homozygous 3.0 (1.3-7.7), AT (<60% activity) 3.0 (95% CI 0.96-9.6). In Conclusion, in patients with a first spontaneous VTE the yearly recurrence rate of 5% is more than doubled in the presence of relevant thrombophilic risk factors supporting the need of long-term oral anticoagulant therapy after a first idiopathic VTE. In contrast to current ACCP recommendations, thrombophilic risk factors are of clinical relevance. Disclosures: No relevant conflicts of interest to declare.

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Cost–effectiveness of second-line nivolumab for platinum-treated advanced non-small-cell lung cancer

Journal of Comparative Effectiveness Research ◽

10.2217/cer-2020-0053 ◽

2020 ◽

Vol 9 (18) ◽

pp. 1301-1309

Author(s):

Longfeng Zhang ◽

Xiaofang Zeng ◽

Hongfu Cai ◽

Na Li ◽

Maobai Liu ◽

...

Keyword(s):

Lung Cancer ◽

Cost Effectiveness ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Phase Iii ◽

Second Line ◽

Small Cell Lung ◽

The Cost ◽

Quality Adjusted Life

Aim: To analyze the economic impact of nivolumab and chemotherapy in patients with non-small-cell lung cancer (NSCLC) who developed disease progression after platinum-containing dual-drug chemotherapy. Materials & methods: The partitioned survival model was used to analyze the cost-utility of two NSCLC treatments by nivolumab and docetaxel. The clinical data resulted from the Phase III clinical trial. The cost parameters were derived from our previous studies, and the utility parameters were derived from the literature. Results: The quality-adjusted life-years of nivolumab and docetaxel were 0.778 and 0.336. The lifetime direct medical expenses of nivolumab and docetaxel were US$44,707.17 and US$12,826.72. The incremental cost–effectiveness ratio was $72,127.71/quality-adjusted life-year. Conclusion: The combination of chemotherapy, nivolumab is not a cost-effective choice in the second-line treatment of NSCLC.

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Frailty Phenotype and Healthcare Costs in Women in Late Life: The SOF study

Innovation in Aging ◽

10.1093/geroni/igaa057.2814 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 778-778

Author(s):

Lisa Langsetmo ◽

Allyson Kats ◽

John Schousboe ◽

Tien Vo ◽

Brent Taylor ◽

...

Keyword(s):

Healthcare Costs ◽

Functional Limitations ◽

Late Life ◽

Cost Ratio ◽

Deficit Accumulation ◽

Frailty Phenotype ◽

Medicare Claims ◽

Accumulation Index ◽

Direct Healthcare Costs ◽

Frailty Indicator

Abstract We used data from 1324 women (mean age 83) at the 2002-2004 exam linked with their Medicare claims to determine the association of the frailty phenotype with healthcare costs. The frailty phenotype was categorized as robust, pre-frail or frail. Multimorbidity and a frailty indicator (approximating the deficit accumulation index) were derived from claims. Functional limitations were assessed by asking about difficulty performing IADL. Total direct healthcare costs were ascertained during 36 months following the exam. Compared with robust, pre-frailty and frailty were associated with higher costs after accounting for demographics, multimorbidity, functional limitations and the frailty indicator (cost ratio 1.37 [1.10-1.71] among pre-frail and 1.63 [1.28-2.08] among frail). Discrimination of high-cost (top decile) women was improved by adding the phenotype and functional limitations to a model containing demographics and the claims-based measures. Findings suggest that assessment of the phenotype may improve identification of individuals at higher risk of costly care.

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Risk Factors and Prediction Models for Venous Thromboembolism in Ambulatory Patients with Lung Cancer

Healthcare ◽

10.3390/healthcare9060778 ◽

2021 ◽

Vol 9 (6) ◽

pp. 778

Author(s):

Ann-Rong Yan ◽

Indira Samarawickrema ◽

Mark Naunton ◽

Gregory M. Peterson ◽

Desmond Yip ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Venous Thromboembolism ◽

High Risk ◽

Prediction Models ◽

Poor Performance ◽

Risk Models ◽

Related Risk ◽

Wide Range ◽

Ambulatory Patients

Venous thromboembolism (VTE) is a significant cause of mortality in patients with lung cancer. Despite the availability of a wide range of anticoagulants to help prevent thrombosis, thromboprophylaxis in ambulatory patients is a challenge due to its associated risk of haemorrhage. As a result, anticoagulation is only recommended in patients with a relatively high risk of VTE. Efforts have been made to develop predictive models for VTE risk assessment in cancer patients, but the availability of a reliable predictive model for ambulate patients with lung cancer is unclear. We have analysed the latest information on this topic, with a focus on the lung cancer-related risk factors for VTE, and risk prediction models developed and validated in this group of patients. The existing risk models, such as the Khorana score, the PROTECHT score and the CONKO score, have shown poor performance in external validations, failing to identify many high-risk individuals. Some of the newly developed and updated models may be promising, but their further validation is needed.

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