Author(s)
Franken M1, Leeneman B2, Jochems A3, Schouwenburg M3, Aarts M4, van Akkooi A5, van den Berkmortel F6, van den Eertwegh A7, de Groot J8, van der Hoeven J9, Hospers G10, Kapiteijn E11, Koornstra R12, Kruit W13, Louwman M14, Piersma D15, van Rijn R16, Suijkerbuijk K17, ten Tije A18, Vreugdenhil G19, Wouters M5, van Zeijl M3, Haanen J5, Uyl - de Groot C1
1Erasmus University Rotterdam, Rotterdam, The Netherlands, 2Erasmus University, Rotterdam, The Netherlands, 3Dutch Institute for Clinical Auditing, Leiden, The Netherlands, 4Maastricht University Medical Center, Maastricht, The Netherlands, 5Netherlands Cancer Institute- Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands, 6Zuyderland Medical Center Geleen-Heerlen, Heerlen, The Netherlands, 7VU University Medical Center, Amsterdam, The Netherlands, 8Isala Oncological Center, Zwolle, The Netherlands, 9Radboud university medical center, Amsterdam, The Netherlands, 10University Medical Center Groningen, Groningen, The Netherlands, 11Leiden University Medical Center, Leiden, The Netherlands, 12Radboud university medical center, Nijmegen, The Netherlands, 13ErasmusMC Cancer Institute, Rotterdam, The Netherlands, 14Netherlands Comprehensive Cancer Organisation, Eindhoven, The Netherlands, 15Medical Spectrum Twente, Enschede, The Netherlands, 16Medical Center Leeuwarden, Leeuwarden, The Netherlands, 17University Medical Center Utrecht, Utrecht, The Netherlands, 18Amphia Hospital, Breda, The Netherlands, 19Maxima Medical Center, Veldhoven, The Netherlands
OBJECTIVES: There is limited evidence on costs associated with ipilimumab. We investigated healthcare costs of ipilimumab treatment in Dutch patients with advanced cutaneous melanoma and compared costs across subgroups. METHODS: Data were retrieved from the nation-wide Dutch Melanoma Treatment Registry for patients diagnosed between July 2012 and July 2015. Ipilimumab episode duration was computed from start of ipilimumab until start of a next systemic treatment, death, or last date of follow-up. Costs were determined by applying unit costs to individual patient resource use. Patient subgroups were stratified by experiencing an immune related adverse event (irAE): no irAE, colitis, and irAE other than colitis. RESULTS: A total of 807 patients received ipilimumab in Dutch clinical practice. Baseline characteristics were comparable across subgroups. Mean [median] episode duration was 6.27 [4.61] months. Average total healthcare costs amounted to €81,484, but varied widely (range: €18,131-€160,002). Ipilimumab was the most important cost driver (€73,739; 90.5%). Most patients (65%) received 4 cycles of ipilimumab (average dosage: 240mg [SD:45.6mg]). Other healthcare costs (€7,745) were related to hospital admissions (€3,323), hospital visits (€1.791), diagnostics and imaging (€1,505), radiotherapy (€828), and surgery (€297). Although patients with colitis (n=106) had higher costs for resource use other than ipilimumab (€11,426) compared to patients with other types of irAEs (n=90; €9,850) and patients with no irAE (n=611; €6,796), they had lower total costs (€76,075 versus €87,882 and €81,480, respectively) due to less cycles of ipilimumab. Patients with an irAE other than colitis had a longer (mean [median]) episode duration (7.96 [6.38] months) compared to patients with colitis (6.91 [4.92] months) and patients with no irAE (5.92 [4.28] months). CONCLUSIONS: Healthcare costs associated with ipililumab treatment are considerable in Dutch patients with advanced cutaneous melanoma. Although costs were mainly related to drug costs of ipilimumab, total costs and the distribution of the costs varied significantly across subgroups.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCN110
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Oncology, Sensory System Disorders
