THE EFFECT OF LEVEL OF RESPONSE TO TREATMENT ON ASSOCIATED COSTS AND HEALTHCARE RESOURCE UTILIZATION: A RETROSPECTIVE CHART REVIEW STUDY IN PATIENTS WITH SYMPTOMATIC MULTIPLE MYELOMA
(Abstract release date: 05/19/16)
EHA Library. Leleu H. 06/09/16; 132859; E1310
Ms. Henri Leleu
Contributions
Contributions
Abstract
Abstract: E1310
Type: Eposter Presentation
Background
An increase in incidence rates, treatment lines and use of novel agents, with improved efficacy, has impacted costs associated with treating multiple myeloma (MM). Real-world data are needed to accurately assess resource use and costs.
Aims
To evaluate how response to treatment affects associated costs and healthcare resource utilization (HRU) in the UK, Italy and France.
Methods
Physicians (n=189) retrospectively completed case report forms for patients (pts) with symptomatic MM who, in the 3 months before study start, had experienced disease progression after receiving specific treatment regimens (those most commonly prescribed) or received best supportive care (BSC) and died. Pt characteristics, treatment outcomes, costs and HRU were documented from beginning of last completed treatment line onwards. Pts had received: 2nd-line bortezomib (bor) or lenalidomide (len); 3rd-line bor, len, pomalidomide (pom) or bendamustine (ben); 4th-line bor, len, pom or ben; any regimen at 5th line or above; or BSC only. Costs of medication and resources were estimated based on standardized schedules and national databases.
Results
Data were collected for 1156 pts on active treatment and 126 pts receiving BSC. In all countries, mean monthly costs were lower in pts achieving deeper responses. In the UK, mean monthly costs from start of treatment line until progression were significantly lower (p≤0.05) for pts achieving a very good partial response or complete response (≥VGPR) than for pts achieving a partial response (PR) and for pts with stable or progressive disease (SD+PD) (Table 1). These costs were also numerically lower in Italy. In France, costs for pts with ≥VGPR were lower than for pts with PR and significantly lower (p≤0.05) than for pts with SD+PD (Table 1). Medications accounted for 92% of mean monthly costs in the UK, 88% in Italy and 83% in France. In all countries, when excluding cost of medication on a monthly basis, achievement of ≥VGPR was still associated with lower costs. In terms of healthcare resource use, the proportion of pts hospitalized increased with lesser response to treatment: in the UK, 11%, 16% and 28% of pts with ≥VGPR, PR and SD+PD, respectively, were hospitalized, and similar trends were observed in Italy (13%, 26% and 28%) and France (16%, 24% and 27%). In terms of overall costs for each country, the achievement of ≥VGPR was associated with higher mean total costs than the achievement of ≤PR. Total costs were significantly higher for ≥VGPR compared with costs for all pts combined (UK €71 414 vs €57 717; Italy €51 359 vs €34 496; France €45 831 vs €37 009; all p≤0.05). When medication cost was excluded, there was still a trend for pts with ≥VGPR to incur higher costs. These findings are linked to duration of treatment (DoT) and length of treatment-free interval (TFI). Mean DoT for pts with ≥VGPR was 10 months in the UK and 12 months in Italy and France. In all countries this was significantly longer than for pts with PR and twice as long as that for pts with SD+PD. Similarly, in all countries, TFI until progression for pts with ≥VGPR was significantly longer than for pts with other response levels.
Conclusion
Most of the cost of managing pts with relapsed MM is medication-related. Although overall costs are higher due to longer treatment duration, mean monthly costs for pts achieving a deeper response to treatment were lower compared with those pts who had a lesser response. These findings may be explained by hospitalization rates, as pts who exhibited deeper and better responses to treatment were hospitalized less frequently than those with a lesser response.
Session topic: E-poster
Keyword(s): Multiple myeloma
Type: Eposter Presentation
Background
An increase in incidence rates, treatment lines and use of novel agents, with improved efficacy, has impacted costs associated with treating multiple myeloma (MM). Real-world data are needed to accurately assess resource use and costs.
Aims
To evaluate how response to treatment affects associated costs and healthcare resource utilization (HRU) in the UK, Italy and France.
Methods
Physicians (n=189) retrospectively completed case report forms for patients (pts) with symptomatic MM who, in the 3 months before study start, had experienced disease progression after receiving specific treatment regimens (those most commonly prescribed) or received best supportive care (BSC) and died. Pt characteristics, treatment outcomes, costs and HRU were documented from beginning of last completed treatment line onwards. Pts had received: 2nd-line bortezomib (bor) or lenalidomide (len); 3rd-line bor, len, pomalidomide (pom) or bendamustine (ben); 4th-line bor, len, pom or ben; any regimen at 5th line or above; or BSC only. Costs of medication and resources were estimated based on standardized schedules and national databases.
Results
Data were collected for 1156 pts on active treatment and 126 pts receiving BSC. In all countries, mean monthly costs were lower in pts achieving deeper responses. In the UK, mean monthly costs from start of treatment line until progression were significantly lower (p≤0.05) for pts achieving a very good partial response or complete response (≥VGPR) than for pts achieving a partial response (PR) and for pts with stable or progressive disease (SD+PD) (Table 1). These costs were also numerically lower in Italy. In France, costs for pts with ≥VGPR were lower than for pts with PR and significantly lower (p≤0.05) than for pts with SD+PD (Table 1). Medications accounted for 92% of mean monthly costs in the UK, 88% in Italy and 83% in France. In all countries, when excluding cost of medication on a monthly basis, achievement of ≥VGPR was still associated with lower costs. In terms of healthcare resource use, the proportion of pts hospitalized increased with lesser response to treatment: in the UK, 11%, 16% and 28% of pts with ≥VGPR, PR and SD+PD, respectively, were hospitalized, and similar trends were observed in Italy (13%, 26% and 28%) and France (16%, 24% and 27%). In terms of overall costs for each country, the achievement of ≥VGPR was associated with higher mean total costs than the achievement of ≤PR. Total costs were significantly higher for ≥VGPR compared with costs for all pts combined (UK €71 414 vs €57 717; Italy €51 359 vs €34 496; France €45 831 vs €37 009; all p≤0.05). When medication cost was excluded, there was still a trend for pts with ≥VGPR to incur higher costs. These findings are linked to duration of treatment (DoT) and length of treatment-free interval (TFI). Mean DoT for pts with ≥VGPR was 10 months in the UK and 12 months in Italy and France. In all countries this was significantly longer than for pts with PR and twice as long as that for pts with SD+PD. Similarly, in all countries, TFI until progression for pts with ≥VGPR was significantly longer than for pts with other response levels.
Conclusion
Most of the cost of managing pts with relapsed MM is medication-related. Although overall costs are higher due to longer treatment duration, mean monthly costs for pts achieving a deeper response to treatment were lower compared with those pts who had a lesser response. These findings may be explained by hospitalization rates, as pts who exhibited deeper and better responses to treatment were hospitalized less frequently than those with a lesser response.
Session topic: E-poster
Keyword(s): Multiple myeloma
Abstract: E1310
Type: Eposter Presentation
Background
An increase in incidence rates, treatment lines and use of novel agents, with improved efficacy, has impacted costs associated with treating multiple myeloma (MM). Real-world data are needed to accurately assess resource use and costs.
Aims
To evaluate how response to treatment affects associated costs and healthcare resource utilization (HRU) in the UK, Italy and France.
Methods
Physicians (n=189) retrospectively completed case report forms for patients (pts) with symptomatic MM who, in the 3 months before study start, had experienced disease progression after receiving specific treatment regimens (those most commonly prescribed) or received best supportive care (BSC) and died. Pt characteristics, treatment outcomes, costs and HRU were documented from beginning of last completed treatment line onwards. Pts had received: 2nd-line bortezomib (bor) or lenalidomide (len); 3rd-line bor, len, pomalidomide (pom) or bendamustine (ben); 4th-line bor, len, pom or ben; any regimen at 5th line or above; or BSC only. Costs of medication and resources were estimated based on standardized schedules and national databases.
Results
Data were collected for 1156 pts on active treatment and 126 pts receiving BSC. In all countries, mean monthly costs were lower in pts achieving deeper responses. In the UK, mean monthly costs from start of treatment line until progression were significantly lower (p≤0.05) for pts achieving a very good partial response or complete response (≥VGPR) than for pts achieving a partial response (PR) and for pts with stable or progressive disease (SD+PD) (Table 1). These costs were also numerically lower in Italy. In France, costs for pts with ≥VGPR were lower than for pts with PR and significantly lower (p≤0.05) than for pts with SD+PD (Table 1). Medications accounted for 92% of mean monthly costs in the UK, 88% in Italy and 83% in France. In all countries, when excluding cost of medication on a monthly basis, achievement of ≥VGPR was still associated with lower costs. In terms of healthcare resource use, the proportion of pts hospitalized increased with lesser response to treatment: in the UK, 11%, 16% and 28% of pts with ≥VGPR, PR and SD+PD, respectively, were hospitalized, and similar trends were observed in Italy (13%, 26% and 28%) and France (16%, 24% and 27%). In terms of overall costs for each country, the achievement of ≥VGPR was associated with higher mean total costs than the achievement of ≤PR. Total costs were significantly higher for ≥VGPR compared with costs for all pts combined (UK €71 414 vs €57 717; Italy €51 359 vs €34 496; France €45 831 vs €37 009; all p≤0.05). When medication cost was excluded, there was still a trend for pts with ≥VGPR to incur higher costs. These findings are linked to duration of treatment (DoT) and length of treatment-free interval (TFI). Mean DoT for pts with ≥VGPR was 10 months in the UK and 12 months in Italy and France. In all countries this was significantly longer than for pts with PR and twice as long as that for pts with SD+PD. Similarly, in all countries, TFI until progression for pts with ≥VGPR was significantly longer than for pts with other response levels.
Conclusion
Most of the cost of managing pts with relapsed MM is medication-related. Although overall costs are higher due to longer treatment duration, mean monthly costs for pts achieving a deeper response to treatment were lower compared with those pts who had a lesser response. These findings may be explained by hospitalization rates, as pts who exhibited deeper and better responses to treatment were hospitalized less frequently than those with a lesser response.
Session topic: E-poster
Keyword(s): Multiple myeloma
Type: Eposter Presentation
Background
An increase in incidence rates, treatment lines and use of novel agents, with improved efficacy, has impacted costs associated with treating multiple myeloma (MM). Real-world data are needed to accurately assess resource use and costs.
Aims
To evaluate how response to treatment affects associated costs and healthcare resource utilization (HRU) in the UK, Italy and France.
Methods
Physicians (n=189) retrospectively completed case report forms for patients (pts) with symptomatic MM who, in the 3 months before study start, had experienced disease progression after receiving specific treatment regimens (those most commonly prescribed) or received best supportive care (BSC) and died. Pt characteristics, treatment outcomes, costs and HRU were documented from beginning of last completed treatment line onwards. Pts had received: 2nd-line bortezomib (bor) or lenalidomide (len); 3rd-line bor, len, pomalidomide (pom) or bendamustine (ben); 4th-line bor, len, pom or ben; any regimen at 5th line or above; or BSC only. Costs of medication and resources were estimated based on standardized schedules and national databases.
Results
Data were collected for 1156 pts on active treatment and 126 pts receiving BSC. In all countries, mean monthly costs were lower in pts achieving deeper responses. In the UK, mean monthly costs from start of treatment line until progression were significantly lower (p≤0.05) for pts achieving a very good partial response or complete response (≥VGPR) than for pts achieving a partial response (PR) and for pts with stable or progressive disease (SD+PD) (Table 1). These costs were also numerically lower in Italy. In France, costs for pts with ≥VGPR were lower than for pts with PR and significantly lower (p≤0.05) than for pts with SD+PD (Table 1). Medications accounted for 92% of mean monthly costs in the UK, 88% in Italy and 83% in France. In all countries, when excluding cost of medication on a monthly basis, achievement of ≥VGPR was still associated with lower costs. In terms of healthcare resource use, the proportion of pts hospitalized increased with lesser response to treatment: in the UK, 11%, 16% and 28% of pts with ≥VGPR, PR and SD+PD, respectively, were hospitalized, and similar trends were observed in Italy (13%, 26% and 28%) and France (16%, 24% and 27%). In terms of overall costs for each country, the achievement of ≥VGPR was associated with higher mean total costs than the achievement of ≤PR. Total costs were significantly higher for ≥VGPR compared with costs for all pts combined (UK €71 414 vs €57 717; Italy €51 359 vs €34 496; France €45 831 vs €37 009; all p≤0.05). When medication cost was excluded, there was still a trend for pts with ≥VGPR to incur higher costs. These findings are linked to duration of treatment (DoT) and length of treatment-free interval (TFI). Mean DoT for pts with ≥VGPR was 10 months in the UK and 12 months in Italy and France. In all countries this was significantly longer than for pts with PR and twice as long as that for pts with SD+PD. Similarly, in all countries, TFI until progression for pts with ≥VGPR was significantly longer than for pts with other response levels.
Conclusion
Most of the cost of managing pts with relapsed MM is medication-related. Although overall costs are higher due to longer treatment duration, mean monthly costs for pts achieving a deeper response to treatment were lower compared with those pts who had a lesser response. These findings may be explained by hospitalization rates, as pts who exhibited deeper and better responses to treatment were hospitalized less frequently than those with a lesser response.
Session topic: E-poster
Keyword(s): Multiple myeloma
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