Catherine Muehlenbein

Cost-Effectiveness of Pemetrexed as First-Line Maintenance Therapy for Advanced Nonsquamous Non-small Cell Lung Cancer

Introduction: The primary objective was to estimate the cost-effectiveness of maintenance therapy with pemetrexed (Pem) compared with observation, each with best supportive care, in patients with advanced non-small cell lung cancer (NSCLC) who have completed, without progression, at least four cycles of first-line platinum chemotherapy, particularly in those with nonsquamous cell histology. Secondary comparisons included Pem with erlotinib (Erl) or Pem with bevacizumab (Bev). Methods: A semi-Markov model was developed to compare the 3-year impact of Pem with three other alternatives for maintenance therapy from a United States payer perspective. Data from randomized controlled clinical trials provided clinical inputs. Medicare reimbursement rates were used to determine drug costs. A retrospective claims database analysis was used to obtain estimates of other direct NSCLC-related costs. Results: In the prespecified subset of patients with nonsquamous cell histology only, the incremental cost per life-year gained was

Healthcare Costs and Workloss Burden of Patients with Chemotherapy-Associated Peripheral Neuropathy in Breast, Ovarian, Head and Neck, and Nonsmall Cell Lung Cancer

122,371 for Pem to observation and

Cost-Effectiveness of Pemetrexed Plus Cisplatin as First-Line Therapy for Advanced Nonsquamous Non-small Cell Lung Cancer

150,260 for Pem to Erl, and Bev was dominated by Pem. In all patients with advanced NSCLC regardless of histologic subtype, using Pem as maintenance therapy led to an incremental cost per life-year gained of

Evaluation of the Reliability of Electronic Medical Record Data in Identifying Comorbid Conditions among Patients with Advanced Non-Small Cell Lung Cancer

205,597 compared with observation and

An exploratory subgroup analysis of race and gender in squamous cancer of the head and neck: Inferior outcomes for African American males in the LORHAN database

312,341 compared with Erl. Conclusions: Compared with observation and other agents used and/or reimbursed for maintenance therapy in advanced NSCLC, Pem may be considered cost-effective, particularly in patients with nonsquamous cell histology. This analysis is the first to evaluate the cost-effectiveness of maintenance therapy in advanced NSCLC and emphasizes the importance of histology in identifying the appropriate patient for Pem maintenance therapy.

Treatment Decisions for Advanced Non-Squamous Non-Small Cell Lung Cancer: Patient and Physician Perspectives on Maintenance Therapy

Objective. Chemotherapy-associated peripheral neuropathy (CAPN) is a painful side-effect of chemotherapy. This study assesses healthcare and workloss costs of CAPN patients with breast, ovarian, head/neck, or non-small cell lung cancer (NSCLC) from a third-party payor/employer perspective. Research Design and Methods. Patients with qualifying tumors, and claims for chemotherapy and services indicative of peripheral neuropathy (PN) within 9-months of chemotherapy (cases) were identified in a administrative claims database. Cases were matched 1 : 1 to controls with no PN-related claims based on demographics, diabetes history and propensity for having a diagnosis of PN during the study period (based on resource use and comorbidities in a 3-month baseline period). Average all-cause healthcare costs, resource use and workloss burden were determined. Results. Average healthcare costs were

Treatment Patterns by EGFR Mutation Status in Non-Small Cell Lung Cancer Patients in the USA: A Retrospective Database Analysis

17,344 higher for CAPN cases than their non-CAPN controls, with outpatient costs being the highest component (with cases having excess costs of

Physician decisions related to maintenance therapy for advanced non-small cell lung cancer (NSCLC) in the United States (US).

8,092). On average, each CAPN case had 12 more outpatient visits than controls, and spent more days in the hospital. Workloss burden was higher for cases but not statistically different from controls. Conclusion. This study establishes that breast, ovarian, head/neck, or NSCLC patients with CAPN have significant excess healthcare costs and resource use.

PCN25 THE BUDGETARY IMPACT OF PEMETREXED MAINTENANCE THERAPY FOR ADVANCED NONSQUAMOUS NON-SMALL CELL LUNG CANCER

Introduction: To estimate the cost-effectiveness of first-line cisplatin/pemetrexed (Cis/Pem) compared with cisplatin/gemcitabine (Cis/Gem), carboplatin/paclitaxel (Carb/Pac), and carboplatin/paclitaxel/bevacizumab (Carb/Pac/Bev) in patients with advanced non-small cell lung cancer (NSCLC), particularly in those with nonsquamous cell histology (i.e., adenocarcinoma, large cell carcinoma, or histology not otherwise specified). Methods: A semi-Markov model was developed to compare the 2-year impact of Cis/Pem to three other first-line regimens from the U.S. payer perspective. Data from the randomized controlled clinical trial of Cis/Pem versus Cis/Gem and a mixed treatment comparison model (no head-to-head data were available for the Cis/Pem to Carb/Pac or Carb/Pac/Bev comparisons) provided clinical inputs. Medicare reimbursement rates were used to determine drug costs. A retrospective claims database analysis was used to obtain estimates of other direct NSCLC-related costs. Results: In all patients with advanced NSCLC regardless of histologic subtype, using Cis/Pem as first-line chemotherapy led to an incremental cost per life-year gained (LYG) of

Impact of comorbidities on clinical and economic outcomes among patients with advanced non-small cell lung cancer (NSCLC) receiving care in the community-based outpatient setting.

104,577 for Cis/Pem to Cis/Gem and