Methods: A hybrid decision-analytic model was developed to estimate the cost and health outcomes of NSCLC patients comparing the current testing scenario vs a notesting scenario. Current distribution of ALK testing techniques and the sensitivity and specificity data were retrieved from the literature. Target treatments were based on expert opinion and test results. For each treatment, a 3-states Markov model was developed, where progression-free survival (PFS) and overall survival (OS) curves were parameterized using exponential extrapolations to model transition of patients among health states (lifetime horizon). A Spanish Health System perspective was used and 3% discount rate applied. Deterministic and probabilistic sensitivity analyses were performed to address uncertainty. abstracts Annals of Oncology Volume 31 -Issue S4 -2020 S871
Objectives: To understand the economic and humanistic burden attributed to myasthenia gravis (MG). Methods: We conducted a literature search (January 2009 to April 2019) in the biomedical database Embase (including Medline), focusing on English language observational studies and economic models evaluating patients with MG in the United States. Key search terms focused on costs, healthcare resource utilization, and quality of life (QoL). Results: A total of 18 studies were identified that included economic or humanistic burden data. Median length of hospitalization in patients with MG ranged from 2 days to 8 days, with costs per admission, using National Inpatient Sample data, ranging from a median of $16,000 in 1 study to a mean of nearly $99,000 in another analysis. Patient factors including MG crisis, presence of respiratory failure, and complex medication regimens (including multiple immunosuppressive and conventional therapies) worsened the burden, increasing length of stay from a median of 4 -6 days to 6 -10 days. Costs of admission increased from $16,000 to $26,600 for patients hospitalized for MG (not MG crisis), up to almost $54,000 for patients experiencing an MG crisis and receiving plasma exchange. Among patients treated with multiple immunosuppressants, presence of continued functional disability contributed to a worse QoL. One study found that QoL was worse in women than men, but the difference was eliminated for women who had undergone a thymectomy. Conclusions: The economic and humanistic burden associated with MG is considerable, particularly for patients with severe complications, including MG crisis. Understanding the risk factors associated with MG-related complications, and the potential impact on treatment modalities, is crucial to improve the medical management of these patients. Additionally, there is a clear unmet need in this patient population for new treatment options to improve disease course and prevent complications.
Aim: Evaluate health-related quality of life (HRQoL) and health utility impact of single-agent selinexor in heavily pretreated patients with relapsed/refractory diffuse large B-cell lymphoma. Patients & methods: Functional Assessment of Cancer Therapy (FACT) – Lymphoma and EuroQoL five-dimensions five-levels data collected in the single-arm Phase IIb trial SADAL (NCT02227251) were analyzed with mixed-effects models. Results: Treatment responders maintained higher FACT – Lymphoma (p ≤ 0.05), FACT – General (p < 0.05) and EuroQoL five-dimensions five-levels index scores (p < 0.001) beginning in cycle 3. The estimated difference in health state utilities for treatment response and progressive disease was both statistically significant and clinically meaningful (mean difference: 0.07; p = 0.001). Conclusion: In patients with relapsed/refractory diffuse large B-cell lymphoma, objective response to selinexor was associated with HRQoL maintenance, reduction in disease-related HRQoL decrements and higher health utilities.
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