Hospitalisation costs of metastatic melanoma in France; the MELISSA study (MELanoma In hoSpital coSts Assessment)

Fernandes, Jérôme; Bregman, Bruno; Combemale, P.; Amaz, Camille; Léotoing, Lucie de; Vainchtock, Alexandre; Gaudin, Anne-Françoise

doi:10.1186/s12913-017-2472-0

Cited by 4 publications

(6 citation statements)

References 20 publications

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“…current 2019 U.S. dollars, is roughly $5,720. 35 This estimate falls within the range of annualized PPPM costs associated with hospitalizations reported in this study across first-line treatment groups ($4,452-$12,798). Additional studies in the United States assessing costs of care for metastatic melanoma that consider contemporary, recently approved systemic therapies are needed to make further comparisons to the results of the current study.…”

supporting

confidence: 67%

Health Care Resource Utilization and Costs in First-Line Treatments for Patients with Metastatic Melanoma in the United States

Klink

Chmielowski

Feinberg

et al. 2019

JMCP

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BACKGROUND: The treatment landscape for patients with metastatic melanoma has changed dramatically with the introduction of novel therapies, such as targeted therapies and immunotherapies, in recent years. Health care resource utilization (HCRU) and cost data are needed to further evaluate these treatments in a value-based health care system. OBJECTIVE: To examine HCRU and total cost of care among U.S. metastatic melanoma patients treated with first-line systemic therapies, including immunotherapies, targeted therapies, and chemotherapy.METHODS: A retrospective observational study was conducted using a U.S. claims database. Adults with ≥ 2 claims for melanoma and ≥ 1 claim for metastasis between January 1, 2012, and June 30, 2017, were identified. Patients had pharmacy and medical enrollment ≥ 6 months before and ≥ 3 months following first-line treatment start. Per patient per month (PPPM) HCRU and costs were calculated by first-line treatment drug class: PD-1 inhibitors, CTLA-4 inhibitors, CTLA-4 + PD-1 combination, BRAF monotherapy, BRAF + MEK combination, and chemotherapy. Adjusted odds ratios (ORs) for HCRU were estimated by logistic regressions and adjusted costs were estimated by generalized linear models using log-link with gamma distribution to control for differences in patient characteristics across groups. RESULTS: Among 1,599 metastatic melanoma patients (PD-1, n = 255; CTLA-4, n = 555; CTLA-4 + PD-1, n = 88; BRAF, n = 210; BRAF + MEK, n=102; chemotherapy=389), mean age ranged from 59-68 years, and the majority were male (62%). Any hospitalization during first-line treatment was less frequent among PD-1-treated patients (25.9%) compared with 34.7%-45.5% of all other groups (all P < 0.05). PPPM hospitalizations were lowest in PD-1 (0.06) compared with 0.09-0.16 across all other groups (all P < 0.05), and PPPM emergency department (ED) visits were lowest in PD-1 (0.09) compared with 0.13-0.18 across all other groups (all P < 0.05), except for BRAF + MEK (0.14, P = 0.08). CTLA-4, CTLA-4 + PD-1, and BRAF + MEK had increased odds of hospitalization compared to PD-1 (adjusted ORs = 2.10, 2.35, 2.15, respectively; all P < 0.05

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supporting

confidence: 67%

Health Care Resource Utilization and Costs in First-Line Treatments for Patients with Metastatic Melanoma in the United States

Klink

Chmielowski

Feinberg

et al. 2019

JMCP

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“…Generally, melanoma progression and changes in prognosis impact the use and allocation of healthcare resources and the economic burden [ 33 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…It has been observed that hospitalization costs related to melanoma increase approximately fourfold with disease progression; new therapies may delay the risk of relapse, but the acquisition cost and, in certain cases, their long-term use or drug toxicity increase the cost of melanoma care [ 9 , 42 , 44 , 45 ]. More recently, it has been observed that MM patients treated with at least one dose of the anti-CTLA-4 inhibitor ipilimumab need various types of healthcare services and that the economic burden associated with a drug-refractory disease is high.…”

Section: Discussionmentioning

confidence: 99%

A Descriptive Study of Repeated Hospitalizations and Survival of Patients with Metastatic Melanoma in the Northern Italian Region during 2004–2019

et al. 2023

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Background: Survival rates for metastatic melanoma (MM) patients have improved in recent years, leading to major expenses and health resource use. We conducted a non-concurrent prospective study to describe the burden of hospitalization in a real-world setting for patients with MM. Methods: Patients were tracked throughout all hospital stays in 2004–2019 by means of hospital discharges. The number of hospitalizations, the rehospitalization rate, the average time spent in the hospital and the time span between consecutive admissions were evaluated. Relative survival was also calculated. Results: Overall, 1570 patients were identified at the first stay (56.5% in 2004–2011 and 43.7% in 2012–2019). A total of 8583 admissions were retrieved. The overall rehospitalization rate was 1.78 per patient/year (95%CI = 1.68–1.89); it increased significantly with the period of first stay (1.51, 95%CI = 1.40–1.64 in 2004–2011 and 2.11, 95%CI = 1.94–2.29 thereafter). The median time span between hospitalizations was lower for patients hospitalized after 2011 (16 vs. 26 months). An improvement in survival for males was highlighted. Conclusions: The hospitalization rate of patients with MM was higher in the last years of the study. Compared with a shorter length of stay, patients were admitted to hospitals with a higher frequency. Knowledge of the burden of MM is essential for planning the allocation of healthcare resources.

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“…The largest cost drivers in France, Germany and the United Kingdom are medications and hospitalisation and/or emergency department treatment [ 127 ]. Adverse events from the use of new treatments are also responsible for a sizable cost burden [ 128 , 129 ].…”

Section: Harms Of Exposure To Uv Radiationmentioning

confidence: 99%

The effects of exposure to solar radiation on human health

Neale

Lucas

Byrne

et al. 2023

Photochem Photobiol Sci

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This assessment by the Environmental Effects Assessment Panel (EEAP) of the Montreal Protocol under the United Nations Environment Programme (UNEP) evaluates the effects of ultraviolet (UV) radiation on human health within the context of the Montreal Protocol and its Amendments. We assess work published since our last comprehensive assessment in 2018. Over the last four years gains have been made in knowledge of the links between sun exposure and health outcomes, mechanisms, and estimates of disease burden, including economic impacts. Of particular note, there is new information about the way in which exposure to UV radiation modulates the immune system, causing both harms and benefits for health. The burden of skin cancer remains high, with many lives lost to melanoma and many more people treated for keratinocyte cancer, but it has been estimated that the Montreal Protocol will prevent 11 million cases of melanoma and 432 million cases of keratinocyte cancer that would otherwise have occurred in the United States in people born between 1890 and 2100. While the incidence of skin cancer continues to rise, rates have stabilised in younger populations in some countries. Mortality has also plateaued, partly due to the use of systemic therapies for advanced disease. However, these therapies are very expensive, contributing to the extremely high economic burden of skin cancer, and emphasising the importance and comparative cost-effectiveness of prevention. Photodermatoses, inflammatory skin conditions induced by exposure to UV radiation, can have a marked detrimental impact on the quality of life of sufferers. More information is emerging about their potential link with commonly used drugs, particularly anti-hypertensives. The eyes are also harmed by over-exposure to UV radiation. The incidence of cataract and pterygium is continuing to rise, and there is now evidence of a link between intraocular melanoma and sun exposure. It has been estimated that the Montreal Protocol will prevent 63 million cases of cataract that would otherwise have occurred in the United States in people born between 1890 and 2100. Despite the clearly established harms, exposure to UV radiation also has benefits for human health. While the best recognised benefit is production of vitamin D, beneficial effects mediated by factors other than vitamin D are emerging. For both sun exposure and vitamin D, there is increasingly convincing evidence of a positive role in diseases related to immune function, including both autoimmune diseases and infection. With its influence on the intensity of UV radiation and global warming, the Montreal Protocol has, and will have, both direct and indirect effects on human health, potentially changing the balance of the risks and benefits of spending time outdoors. Graphical abstract

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Hospitalisation costs of metastatic melanoma in France; the MELISSA study (MELanoma In hoSpital coSts Assessment)

Cited by 4 publications

References 20 publications

Health Care Resource Utilization and Costs in First-Line Treatments for Patients with Metastatic Melanoma in the United States

Health Care Resource Utilization and Costs in First-Line Treatments for Patients with Metastatic Melanoma in the United States

A Descriptive Study of Repeated Hospitalizations and Survival of Patients with Metastatic Melanoma in the Northern Italian Region during 2004–2019

The effects of exposure to solar radiation on human health

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