RESOURCE USE AND ASSOCIATED COSTS OF MANAGING DOCETAXEL-RELATED NEUTROPENIC SEPSIS IN PATIENTS WITH ADVANCED NON-SMALL CELL LUNG CANCER IN THE UK NHS- REVEAL-NS
Author(s)
Pulfer A1, Hodgson M2, Patel A2, Purchase J2, Summerhayes M2, Newsom-Davis T3
1pH Associates Ltd (an Open Health company), Marlow, UK, 2Roche Products Ltd, Welwyn Garden City, UK, 3Chelsea & Westminster Hospital, London, UK
OBJECTIVES: To describe the real-world rate, and health care resource use associated with neutropenic sepsis (NS) in patients with relapsed advanced non-small cell lung cancer (NSCLC) treated with single-agent docetaxel. To compare the outcomes with those previously published by the National Institute of Health and Care Excellence (NICE) in technology appraisals for NSCLC. METHODS: A retrospective observational study in seven UK centres of 121 patients with locally advanced/metastatic NSCLC; aged ≥18 years; docetaxel monotherapy post-progression or intolerance to ≥1 line of chemotherapy. Microcosting analysis of resource use data performed using British National Formulary for medicines, and NHS National Tariff Payment System/Department of Health reference costs for hospital admissions/attendances. [ClinicalTrials.gov: NCT02658747]. RESULTS: Eleven patients (9.1%) had an episode of NS confirmed by ANC ≤1.0x10/L and temperature >38°C or other signs or symptoms consistent with NS, and 10 (8.3%) an episode of suspected NS. Twenty-four patients (19.8%) received prophylactic granulocyte colony-stimulating factor. Twenty-one (17.4%) patients were treated for NS, 9 (7.4%) for anaemia, and 5 (4.1%) for neutropenia without sepsis. All NS episodes (100.0%) required unplanned hospital admission; mean (standard deviation [SD]) admission cost: £2,233.65 (£2,310.01). Mean (SD) cost of managing patients with confirmed NS: £3,163.23 (£2,921.00); suspected NS: £1,789.81 (£1,585.32). CONCLUSIONS: There has been limited to no consensus on the true rate and cost of NS in NICE technology appraisals historically, with costs ranging from £1750-£7332; and rates from 2.9%-12.7%. This real world study identified a higher rate of NS than previously reported through meta-analyses of clinical trials, and most NICE appraisals. Further, it found all patients with suspected/confirmed NS required an unplanned admission to manage the episode, resulting in a higher cost of management than reported in most NICE appraisals. These results should be considered for use within cost effectiveness analyses in future submissions to health technology assessment bodies.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCN192
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Oncology