There is limited evidence on the costs associated with ipilimumab. We investigated healthcare costs of all Dutch patients with advanced cutaneous melanoma who were treated with ipilimumab. Data were retrieved from the nation-wide Dutch Melanoma Treatment Registry. Costs were determined by applying unit costs to individual patient resource use. A total of 807 patients who were diagnosed between July 2012 and July 2015 received ipilimumab in Dutch practice. The mean (median) episode duration was 6.27 (4.61) months (computed from the start of ipilimumab until the start of a next treatment, death, or the last date of follow-up). The average total healthcare costs amounted to &OV0556;81 484, but varied widely (range: &OV0556;18 131-&OV0556;160 002). Ipilimumab was by far the most important cost driver (&OV0556;73 739). Other costs were related to hospital admissions (&OV0556;3323), hospital visits (&OV0556;1791), diagnostics and imaging (&OV0556;1505), radiotherapy (&OV0556;828), and surgery (&OV0556;297). Monthly costs for resource use other than ipilimumab were &OV0556;1997 (SD: &OV0556;2629). Treatment-naive patients (n=344) had higher total costs compared with previously-treated patients (n=463; &OV0556;85 081 vs. &OV0556;78 811). Although patients with colitis (n=106) had higher costs for resource use other than ipilimumab (&OV0556;11 426) compared with patients with other types of immune-related adverse events (n=90; &OV0556;9850) and patients with no immune-related adverse event (n=611; &OV0556;6796), they had lower total costs (&OV0556;76 075 vs. &OV0556;87 882 and &OV0556;81 480, respectively). In conclusion, this nation-wide study provides valuable insights into the healthcare costs of advanced cutaneous melanoma patients who were treated with ipilimumab in clinical practice. Most of the costs were attributable to ipilimumab, but the costs and its distribution varied considerably across subgroups.
A431visit/death. HRCU (aNSCLC-related hospital/ER visits, surgeries, radiotherapy, ancillary care [hospice, nursing home, in-home], biomarker tests) and systemic treatment use was extracted from medical charts. Country-specific unit costs, inflated to 2016€ , were multiplied by HCRU to derive aNSCLC-related costs. Results: Of 138 patients (n= 52 England, 57 Netherlands, 29 Sweden; n= 42 SQ, 96 NSQ), 95.7% were followed through death (median observation time: 16.5 months [4.0-68.6]). From diagnosis through most recent visit/death, 44.2% of patients were hospitalized (median duration: 0.8 days/patient-month); 25.4% had ≥ 1 ER visit; 44.9% radiotherapy; 3.4% surgery; 23.2% received ancillary care. Median total per-patient costs were
Background:The phase III IMspire150 study (NCT02908672) demonstrated that combination therapy with inhibitors of PD-L1 (atezolizumab [A]), BRAF (vemurafenib [V]), and MEK (cobimetinib [C]) improved investigator-assessed PFS vs placebo (P)+V+C (hazard ratio [HR] 0.78; 95% CI 0.63-0.97; log-rank P¼0.025). An exploratory analysis was conducted to define efficacy outcomes in key prognostic subgroups defined by baseline PD-L1 and LDH status.
Achieving a response also leads to longer treatment duration. Targeted therapies in HER2+ mBC are generally associated with higher response rate, longer treatment duration and therefore lower monthly HRU.
utility values. ConClusions: Mapping non-preference based disease specific QoL to generic preference-based QoL may facilitate economic evaluations. However, the external validity of mapping algorithms may be hampered in different types of cancer, different disease stages, and different patient populations. Mapping algorithms should, therefore, be used with caution. It remains crucial to collect generic preference-based QoL data in different patient populations.
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