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Research Article

7 September 2018

Costs associated with adverse events for systemic therapies in metastatic melanoma

Authors: Alex Z Fu, Zhiyi Li, Jackson Tang [email protected], Syed Mahmood, Tyler Whisman, and Ying QiuAuthor Info & Affiliations

Publication: J. Comp. Eff. Res.

Volume 7, Number 9

https://doi.org/10.2217/cer-2018-0022

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Abstract

Aim: To determine the costs of adverse events (AEs) associated with current metastatic melanoma (MM) therapies. Materials & methods: Two retrospective cohort studies were independently conducted using the PharMetrics and MarketScan databases. Included patients were aged ≥18 years, and had ≥1 MM diagnosis and ≥1 claim for systemic therapy from 2004 to 2015. Results: A total of 1654 and 1329 patients were identified in PharMetrics and MarketScan, respectively. The corresponding adjusted 30-day incremental costs of AEs by category were highest for CNS/psychiatric (US$21,277 and $18,739), gastrointestinal ($18,534 and $15,648), respiratory ($17,338 and $17,064), cardiovascular ($16,083 and $15,430), hematological/lymphatic ($14,997 and $15,538) and metabolic/nutritional AEs ($12,340 and $17,251). Conclusion: The costs of AEs associated with systemic therapies for MM are substantial.

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References

Papers of special note have been highlighted as: • of interest; •• of considerable interest

1.

Howlader N, Noone AM, Krapcho M et al. SEER cancer statistics review, 1975–2011. National Cancer Institute, MD, USA (2015). http://seer.cancer.gov/csr/1975_2011/.

2.

Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J. Clin. 68(1), 7–30 (2018).

3.

National Cancer Institute. SEER stat fact sheets: melanoma of the skin (2017). http://seer.cancer.gov/statfacts/html/melan.html.

4.

Chang AE, Karnell LH, Menck HR. The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer 83(8), 1664–1678 (1998).

5.

Finn L, Markovic SN, Joseph RW. Therapy for metastatic melanoma: the past, present, and future. BMC Med. 10, 23 (2012).

6.

Guy GP Jr, Ekwueme DU, Tangka FK, Richardson LC. Melanoma treatment costs: a systematic review of the literature, 1990–2011. Am. J. Prev. Med. 43(5), 537–545 (2012).

7.

Davis KL, Mitra D, Kotapati S, Ibrahim R, Wolchok JD. Direct economic burden of high-risk and metastatic melanoma in the elderly: evidence from the SEER-Medicare linked database. Appl. Health Econ. Health Policy 7(1), 31–41 (2009).

8.

Hodi FS, O'Day SJ, McDermott DF et al. Improved survival with ipilimumab in patients with metastatic melanoma. N. Engl. J. Med. 363(8), 711–723 (2010).

9.

McArthur GA, Chapman PB, Robert C et al. Safety and efficacy of vemurafenib in BRAF(V600E) and BRAF(V600K) mutation-positive melanoma (BRIM-3): extended follow-up of a Phase 3, randomised, open-label study. Lancet Oncol. 15(3), 323–332 (2014).

10.

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: melanoma. Version 3.2016. (2016). https://www.nccn.org/professionals/physician_gls/pdf/melanoma.pdf.

11.

Voskens CJ, Goldinger SM, Loquai C et al. The price of tumor control: an analysis of rare side effects of anti-CTLA-4 therapy in metastatic melanoma from the ipilimumab network. PLoS ONE 8(1), e53745 (2013).

12.

Flaherty K, Robert C, Hersey P et al. Improved survival with MEK inhibition in BRAF-mutated melanoma. N. Engl. J. Med. 367(2), 107–114 (2012).

13.

Long G, Stroyakovsky D, Gogas H et al. COMBI-d: a randomized, double-blinded, Phase III study comparing the combination of dabrafenib and trametinib to dabrafenib and trametinib placebo as first-line therapy in patients with unresectable or metastatic BRAF V600E/K mutation-positive cutaneous melanoma. J. Clin. Oncol. 32(Suppl.), Abstract 9011 (2014).

14.

Hauschild A, Grob J, Demidov L et al. Dabrafenib in BRAF-mutated metastatic melanoma: a multicentre, open-label, Phase 3 randomised controlled trial. Lancet 380(9839), 358–365 (2012).

15.

Chapman P, Hauschild A, Robert C et al. Improved survival with vemurafenib in melanoma with BRAF V600E mutation. N. Engl. J. Med. 364(26), 2507–2516 (2011).

16.

Arondekar B, Curkendall S, Monberg M et al. Economic burden associated with adverse events in patients with metastatic melanoma. J. Manag. Care Spec. Pharm. 21(2), 158–164 (2015).

•• The authors designed the algorithm used in the current study. Their study is an interesting read and compliments the current paper well.

17.

Vouk K, Benter U, Amonkar MM et al. Cost and economic burden of adverse events associated with metastatic melanoma treatments in five countries. J. Med. Econ. 19(9), 900–912 (2016).

• The authors examine and compare adverse events associated with specific therapy types in metastatic melanoma across five countries.

18.

Chang CL, Schabert VF, Munakata J et al. Comparative healthcare costs in patients with metastatic melanoma in the USA. Melanoma Res. 25(4), 312–320 (2015).

19.

Wehler E, Zhao Z, Pinar Bilir S, Munakata J, Barber B. Economic burden of toxicities associated with treating metastatic melanoma in eight countries. Eur. J. Health Econ. 18(1), 49–58 (2017).

• The authors analyze costs associated with specific adverse events (not categories) using clinician interviews (not claims data), and thus provide an interesting comparison to the current paper.

20.

Blough DK, Ramsey SD. Using generalised linear models to assess medical care costs. Health Serv. Outcomes Res. Methodol. 1, 185–202 (2000).

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