Resource Utilization Among Advanced Squamous and non-Squamous non-Small Cell Lung Cancer Patients Receiving Second-Line Treatment in France, Germany, Italy, and Spain: Results of A Retrospective Medical Chart Review

Abstract

Objectives: To evaluate treatment sequences and associated costs among patients with relapsed/refractory multiple myeloma (RRMM). MethOds: Patients with RRMM between January 2007 and September 2013 were identified from US MarketScan databases. Outcomes included treatment regimen per line (L; 2-4L), sequences of treatment regimens, and cost per line and of progression (2L vs > 2L). All-cause and MM-specific monthly costs captured inpatient, outpatient, emergency department, and drug-related costs, adjusted for censoring. Results: 4449 MM patients initiated a 2L regimen, of whom 38% (n= 1696) progressed to 3L and 15% (n= 689) progressed to 4L. Median follow-up was 14 months (range 1-83). The most frequent 2L regimens were lenalidomide (18%), lenalidomide-dexamethasone (12%), bortezomib-dexamethasone (12%), bortezomib-lenalidomide-dexamethasone (10%), and bortezomib (7%). Of patients whose prior therapy included an immunomodulatory drug (IMiD) (n= 1752), bortezomib-dexamethasone was the most common 2L regimen (17%); for those with no prior IMiD exposure (n= 2697), lenalidomide was the most common 2L (23%). Median time to start of 3L was 5.8 months. Among the 27% of lenalidomide 2L patients who progressed to 3L, 64% had bortezomib-based regimens in 3L. Among the 47% of bortezomib-dexamethasone 2L patients who progressed to 3L, 63% had lenalidomide-based regimens in 3L. MM-specific costs were highest for all patients during the first year of 2L: $122,960 versus $74,573 (12-24 mths), $68,940 (24-36 mths), $59,327 (36+ mths). Drug-related costs accounted for 39-62%, and were dependent on regimen and treatment line. During 0-36 mths, MM-specific costs after progression from 2L were higher by $122,823 compared with costs incurred on 2L. cOnclusiOns: In this study of RRMM patients, 38% progressed to subsequent treatment lines, with variability in 2L regimens and treatment sequences. Highest costs were incurred during the first 12 months of follow-up. The cost of managing progressive disease in RRMM is high, as observed by the difference in costs before and after progression. PCN119 TreaTmeNT STraTegieS, healTh Care reSourCe uSe aNd CoSTS of aggreSSive hiSTologiCal TyPeS of NoN-hodgkiN lymPhomaS iN The Slovak rePubliC. reSulTS from The CroSS-SeCTioNal Survey iN The haemaTology-oNCologiCal CeNTerS

Cost-effectiveness of nivolumab in squamous and non-squamous non-small cell lung cancer in Canada and Sweden: an update with 5-year data

“…For each comparator, the proportions of patients who received subsequent treatment were obtained from the clinical trials (Supplementary material Table S1) 7,8 . The mean duration of subsequent treatment was estimated as 3.5 months based on data from the LENS observational study 28 .…”

Padrões de tratamento, uso de recursos e custo do câncer de pulmão de não pequenas células avançado em instituições brasileiras privadas

“…O uso de recursos para o diagnóstico foi semelhante ao descrito em outros estudos, com quase todos os pacientes sendo submetidos a exames de imagem no diagnóstico, dos quais a TC, a RM e a PET foram os métodos mais utilizados; broncoscopia foi a estratégia de amostragem mais comumente utilizada (Gildea et al, 2017;Solem et al, 2015b). Neste estudo, mais de 90% dos pacientes passaram por visitas de atendimento ambulatorial durante o tratamento com CPNPCa, uma porcentagem maior em comparação com estudos do mundo real da Europa (Migliorino et al, 2017) e dos Estados Unidos (Gildea et al, 2017).…”

“…Neste estudo, mais de 90% dos pacientes passaram por visitas de atendimento ambulatorial durante o tratamento com CPNPCa, uma porcentagem maior em comparação com estudos do mundo real da Europa (Migliorino et al, 2017) e dos Estados Unidos (Gildea et al, 2017). Além disso, 25% dos pacientes foram hospitalizados pelo menos uma vez durante o tratamento com CPNPC, uma taxa maior em comparação com dados da Europa, Estados Unidos e Brasil, com taxas de 0-15,7%, 1-2% e 13,5%, respectivamente (Ferreira et al, 2015;Migliorino et al, 2017;Gildea et al, 2017), também com mediana do tempo de permanência dentro do intervalo daqueles relatados para os estudos na Europa (6-18 dias ou 9,3-12,8 dias), e no Brasil (9,6 dias) (Ferreira et al, 2015;Migliorino et al, 2017;Solem et al, 2015b).…”

“…Os custos referentes ao tratamento com CPNPCa foram de R$ 78.518,3 (ou US$ 24.371,7) por paciente/mês, com a maioria dos custos relacionados à quimioterapia, conforme publicado anteriormente em outros estudos (Honma et al, 2014;Corral et al, 2015;Knust et al, 2017;Migliorino et al, 2017;Solem et al, 2015b). O custo total do paciente por mês neste estudo foi maior do que os relatados na Europa, Estados Unidos, Holanda, Espanha e outros estudos brasileiros (Tanaka et al, 2016;Corral et al, 2015;van der linden et al, 2016;Solem et al, 2015b;McGuire et al, 2015). Algumas diferenças de custo podem ser devidas a diferenças inerentes à metodologia escolhida (Nunes et al, 2017) e a suposições e condução dos estudos (Ó Céilleachair et al, 2013).…”