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Costs differences among monoclonal antibodies-based first-line oncology cancer protocols for breast cancer, colorectal carcinoma and non-Hodgkin's lymphoma

Jakovljevic, Mihajlo LU ; Gutzwiller, Florian ; Schwenkglenks, Matthias ; Milovanovic, Olivera ; Rancic, Nemanja ; Varjacic, Mirjana ; Stojadinovic, Dobrivoje ; Dagovic, Aleksandar and Matter-Walstra, Klazien (2014) In Journal of B.U.ON. 19(3). p.20-1111
Abstract

PURPOSE: To assess and compare the costs of first-line monoclonal antibodies (mAbs) treatment protocols in breast cancer, non-Hodgkin lymphoma and colorectal carcinoma in South-Eastern Europe.

METHODS: A retrospective, bottom-up case series study design was implemented with one-year time horizon and payer's perspective. The study sample size was 265 patients (breast cancer, N=137; colorectal cancer, N=44; and non-Hodgkin lymphoma, N=84), while treatment protocols included adjuvant mAbs: trastuzumab (N=137), bevacizumab (N=28), rituximab (N=16) and cetuximab (N=84). ICD-10 related resources use included history of medical services utilization, chronology (time out of service provision) and unit consumption of examinations, drugs... (More)

PURPOSE: To assess and compare the costs of first-line monoclonal antibodies (mAbs) treatment protocols in breast cancer, non-Hodgkin lymphoma and colorectal carcinoma in South-Eastern Europe.

METHODS: A retrospective, bottom-up case series study design was implemented with one-year time horizon and payer's perspective. The study sample size was 265 patients (breast cancer, N=137; colorectal cancer, N=44; and non-Hodgkin lymphoma, N=84), while treatment protocols included adjuvant mAbs: trastuzumab (N=137), bevacizumab (N=28), rituximab (N=16) and cetuximab (N=84). ICD-10 related resources use included history of medical services utilization, chronology (time out of service provision) and unit consumption of examinations, drugs prescribed, imaging, radiotherapy and surgical procedures provided etc., direct medical and lost productivity costs (€) across treatment groups during 2010-2013.

RESULTS: The average length of observation was 125+97 days per patient. Total mean direct and indirect costs of care were: trastuzumab for breast cancer group € 17,740 per patient; bevacizumab for colorectal carcinoma group €8,775 per patient; cetuximab for colorectal carcinoma group € 27,181 per patient; and rituximab for non-Hodgkin lymphoma group €19,431 per patient. An average mAbs-treated patient incurred €17,897 costs of medical care. The total combined budget of these 330 patients was €4,742,775.

CONCLUSIONS: The use of mAbs strongly correlated with high costs in first-line cancer medical care and dominated other cost domains. Cetuximab-based treatment protocols in colorectal carcinoma patients was substantially more expensive compared to trastuzumab (C50), bevacizumab (C20), and rituximab (C80) alternatives. Extremely high costs of mAbs are the key-issue for Eastern European policy makers by crossing the upper limits of affordability in middle-income economies.

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author
; ; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Antibodies, Monoclonal/economics, Breast Neoplasms/drug therapy, Colorectal Neoplasms/drug therapy, Drug Costs, Female, Humans, Lymphoma, Non-Hodgkin/drug therapy, Male, Retrospective Studies
in
Journal of B.U.ON.
volume
19
issue
3
pages
20 - 1111
publisher
Zerbinis Medical Publ.
external identifiers
  • scopus:84918788258
  • pmid:25536624
ISSN
1107-0625
language
English
LU publication?
no
id
d2091169-8fda-4e45-9cd8-824cdc969bc2
alternative location
https://jbuon.com/pdfs/1111-1120.pdf
date added to LUP
2018-09-01 22:59:52
date last changed
2024-06-24 18:36:34
@article{d2091169-8fda-4e45-9cd8-824cdc969bc2,
  abstract     = {{<p>PURPOSE: To assess and compare the costs of first-line monoclonal antibodies (mAbs) treatment protocols in breast cancer, non-Hodgkin lymphoma and colorectal carcinoma in South-Eastern Europe.</p><p>METHODS: A retrospective, bottom-up case series study design was implemented with one-year time horizon and payer's perspective. The study sample size was 265 patients (breast cancer, N=137; colorectal cancer, N=44; and non-Hodgkin lymphoma, N=84), while treatment protocols included adjuvant mAbs: trastuzumab (N=137), bevacizumab (N=28), rituximab (N=16) and cetuximab (N=84). ICD-10 related resources use included history of medical services utilization, chronology (time out of service provision) and unit consumption of examinations, drugs prescribed, imaging, radiotherapy and surgical procedures provided etc., direct medical and lost productivity costs (€) across treatment groups during 2010-2013.</p><p>RESULTS: The average length of observation was 125+97 days per patient. Total mean direct and indirect costs of care were: trastuzumab for breast cancer group € 17,740 per patient; bevacizumab for colorectal carcinoma group €8,775 per patient; cetuximab for colorectal carcinoma group € 27,181 per patient; and rituximab for non-Hodgkin lymphoma group €19,431 per patient. An average mAbs-treated patient incurred €17,897 costs of medical care. The total combined budget of these 330 patients was €4,742,775.</p><p>CONCLUSIONS: The use of mAbs strongly correlated with high costs in first-line cancer medical care and dominated other cost domains. Cetuximab-based treatment protocols in colorectal carcinoma patients was substantially more expensive compared to trastuzumab (C50), bevacizumab (C20), and rituximab (C80) alternatives. Extremely high costs of mAbs are the key-issue for Eastern European policy makers by crossing the upper limits of affordability in middle-income economies.</p>}},
  author       = {{Jakovljevic, Mihajlo and Gutzwiller, Florian and Schwenkglenks, Matthias and Milovanovic, Olivera and Rancic, Nemanja and Varjacic, Mirjana and Stojadinovic, Dobrivoje and Dagovic, Aleksandar and Matter-Walstra, Klazien}},
  issn         = {{1107-0625}},
  keywords     = {{Antibodies, Monoclonal/economics; Breast Neoplasms/drug therapy; Colorectal Neoplasms/drug therapy; Drug Costs; Female; Humans; Lymphoma, Non-Hodgkin/drug therapy; Male; Retrospective Studies}},
  language     = {{eng}},
  month        = {{12}},
  number       = {{3}},
  pages        = {{20--1111}},
  publisher    = {{Zerbinis Medical Publ.}},
  series       = {{Journal of B.U.ON.}},
  title        = {{Costs differences among monoclonal antibodies-based first-line oncology cancer protocols for breast cancer, colorectal carcinoma and non-Hodgkin's lymphoma}},
  url          = {{https://jbuon.com/pdfs/1111-1120.pdf}},
  volume       = {{19}},
  year         = {{2014}},
}