Lisa M. Hess

Chemotherapy treatment patterns, costs, and outcomes of patients with gastric cancer in the United States: a retrospective analysis of electronic medical record (EMR) and administrative claims data

BackgroundThe aim of this study was to conduct a retrospective database analysis to describe the chemotherapy treatment patterns and outcomes of patients with gastric cancer.MethodsIndividuals diagnosed with gastric cancer were identified from the IMS Oncology Database, which contains electronic medical record (EMR) data collected from a variety of community practices, and the Truven Health MarketScan® Research database, an administrative claims database. Eligible patients were 18xa0years of age or older and had an ICD-9 code 151.0–151.9. Patients were excluded if they had evidence of cancer within 6xa0months of the index diagnosis.ResultsThere were 5257 eligible patients identified in EMR data: 1982 (37.7xa0%) of these patients also had data regarding chemotherapy treatments. Of the 1982 patients who received first-line therapy, 42.3xa0%, 18.1xa0%, and 7.9xa0% went on to receive a second, third, and fourth line of chemotherapy, respectively. There were 11891 eligible patients identified in the administrative database; 5299 (44.6xa0%) had data regarding chemotherapy. Of those initiating chemotherapy, 2888 (54.5xa0%) received a second line and 1598 (30.2xa0%) received a third line of treatment. The average total cost of care during first-line therapy was

Treatment Patterns, Costs, and Survival among Medicare-Enrolled Elderly Patients Diagnosed with Advanced Stage Gastric Cancer: Analysis of a Linked Population-Based Cancer Registry and Administrative Claims Database

40,811 [standard deviation (SD)xa0=xa0

Cost-effectiveness of first-line induction and maintenance treatment sequences in non-squamous non-small cell lung cancer (NSCLC) in the U.S.

49,916], which was incurred over an average of 53.5 (SDxa0=xa063.4) days. A similar pattern was evident in second-line treatment (mean/SD,

Ovarian Cancer Prevention

26,588/

Cost Analyses in the US and Japan: A Cross-Country Comparative Analysis Applied to the PRONOUNCE Trial in Non-Squamous Non-Small Cell Lung Cancer

33,301) over 41.2 (SDxa0=xa055.7) days.ConclusionsCosts and duration of care received vary among gastric cancer patients in the U.S. There is a need to understand which regimens may be associated with better health outcomes and to standardize treatment as appropriate.

Cost-Effectiveness of Olaratumab in Combination with Doxorubicin for Patients with Soft Tissue Sarcoma in the United States

Purpose To assess real-world treatment patterns, health care utilization, costs, and survival among Medicare enrollees with locally advanced/unresectable or metastatic gastric cancer receiving standard first-line chemotherapy. Materials and Methods This was a retrospective analysis of the Surveillance, Epidemiology, and End Results-Medicare linked database (2000~2009). The inclusion criteria were as follows: (1) first diagnosed with locally advanced/unresectable or metastatic gastric cancer between July 1, 2000 and December 31, 2007 (first diagnosis defined the index date); (2) ≥65 years of age at index; (3) continuously enrolled in Medicare Part A and B from 6 months before index through the end of follow-up, defined by death or the database end date (December 31, 2009), whichever occurred first; and (4) received first-line treatment with fluoropyrimidine and/or a platinum chemo-therapy agent. Results In total, 2,583 patients met the inclusion criteria. The mean age at index was 74.8±6.0 years. Over 90% of patients died during follow-up, with a median survival of 361 days for the overall post-index period and 167 days for the period after the completion of first-line chemotherapy. The mean total gastric cancer-related cost per patient over the entire post-index follow-up period was United States dollar (USD) 70,808±56,620. Following the completion of first-line chemotherapy, patients receiving further cancer-directed treatment had USD 25,216 additional disease-related costs versus patients receiving supportive care only (P<0.001). Conclusions The economic burden of advanced gastric cancer is substantial. Extrapolating based on published incidence estimates and staging distributions, the estimated total disease-related lifetime cost to Medicare for the roughly 22,200 patients expected to be diagnosed with this disease in 2014 approaches USD 300 millions.

Patient Experience After Receiving a Diagnosis of Gastric Cancer in the USA

OBJECTIVESnDue to the lack of direct head-to-head trials, there are limited data regarding the comparative effectiveness of induction-maintenance sequences. The objective of this study was to develop a cost-effectiveness model to compare induction-maintenance sequences in the US for the treatment of advanced non-squamous NSCLC.nnnMATERIALS AND METHODSnDecision analytic modelling was used to synthesize the treatment effect and baseline risk estimates for nine induction and maintenance treatment sequences, reflecting treatments used in the US. The model was structured using an area-under-the-curve approach and sensitivity analyses were conducted. Model validation was conducted by an independent third party.nnnRESULTSnAll active maintenance therapy-containing regimens, with the exception of gemcitabine+cisplatin (first-line)→erlotinib (maintenance), were more costly than induction-only regimens. Concerning treatments that may be cost effective, the incremental costs per life-year gained were

Factors Associated with Adherence to and Treatment Duration of Erlotinib Among Patients with Non-Small Cell Lung Cancer

121,425,

Systematic Review of Brain Metastases in Patients With Non–Small-Cell Lung Cancer in the United States, European Union, and Japan

148,994, and

Cost-minimization analysis of pemetrexed/carboplatin with maintenance pemetrexed (PemC) versus paclitaxel/carboplatin/bevacizumab with maintenance bevacizumab (PCB) in nonsquamous non-small cell lung cancer (NS-NSCLC).

191,270 for gemcitabine+cisplatin→erlotinib versus gemcitabine+cisplatin→best supportive care (BSC), pemetrexed+cisplatin→BSC versus gemcitabine+cisplatin→erlotinib, and for pemetrexed+cisplatin→pemetrexed versus pemetrexed+cisplatin→BSC, respectively. All other regimens were found to be dominated (carboplatin+paclitaxel→BSC; carboplatin+paclitaxel→erlotinib; carboplatin+paclitaxel→pemetrexed; bevacizumab+carboplatin+paclitaxel→bevacizumab) or extendedly dominated (cisplatin+gemcitabine→pemetrexed). Sensitivity analyses demonstrated stability.nnnCONCLUSIONSnDepending on the specific cost-effectiveness threshold used by a decision maker, the most cost-effective treatment sequence may include the referent comparator gemcitabine+cisplatin and the studied regimens of gemcitabine+cisplatin→erlotinib, pemetrexed+cisplatin→BSC, or pemetrexed+cisplatin→pemetrexed.