Zheng-Yi Zhou

Investigation of Adverse-Event-Related Costs for Patients With Metastatic Breast Cancer in a Real-World Setting

BACKGROUNDnExisting treatments for metastatic breast cancer (mBC) are often effective but can cause adverse events (AEs). This study aimed to identify AEs associated with chemotherapies commonly used in mBC treatment (phase 1) and to quantify the economic impact of these AEs (phase 2).nnnMATERIALS AND METHODSnPatients in phase 1 had at least one claim for therapy for mBC, with at least one episode with single or multiple agents. The most common chemotherapy-related complications were identified using medical and pharmacy claims data. In phase 2, patients meeting study criteria were divided into four treatment cohorts by the line of treatment and chemotherapy received: first-line taxane-treated patients, second-line taxane-treated patients, first-line capecitabine-treated patients, and second-line capecitabine-treated patients. Average monthly AE-related health care costs per cohort were stratified by cost component. Total monthly costs per number of AEs were also calculated.nnnRESULTSnOn average, patients in phase 1 (n = 1,551) had 2 episodes of treatment, with a mean duration of 131 days. The most frequently noted complications were anemia (50.7% of mBC treatment episodes), bilirubin elevation (26.4%), and leukopenia (24.8%). In phase 2, costs related to AEs were primarily driven by incremental inpatient, outpatient, and pharmacy costs. Increases in average monthly costs ranged from

Budget Impact Analysis of Liposomal Amphotericin B and Amphotericin B Lipid Complex in the Treatment of Invasive Fungal Infections in the United States

854 (9.0%) to

Cost-effectiveness of ceritinib in patients previously treated with crizotinib in anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer in Canada

5,320 (69.5%), according to cohort. Overall costs increased with increasing numbers of AEs.nnnCONCLUSIONnChemotherapy-related AEs in patients with mBC are associated with a substantial economic burden that increases with the number of AEs reported.

Economic Evaluation of Timely Versus Delayed Use of Tumor Necrosis Factor Inhibitors for Treatment of Psoriatic Arthritis in the US

BackgroundLiposomal amphotericin B (L-AMB) and amphotericin B lipid complex (ABLC) are both indicated for treating invasive fungal infections (IFIs) caused by Aspergillus, Candida and Cryptococcus spp. among patients who are refractory to or intolerant of conventional amphotericin B (CAB). Prior studies have suggested similar efficacies but differences in adverse event (AE) profiles between L-AMB and ABLC.ObjectiveOur objective was to conduct a cost-minimisation and budget impact analysis for the treatment of IFIs with L-AMB and ABLC in a US hospital setting.MethodsA Microsoft® Excel-based budget impact model was developed to estimate the costs associated with using L-AMB and ABLC for the treatment of adult patients with Aspergillus, Candida and Cryptococcus spp. infections, who are refractory to or intolerant of CAB, during a hospital stay. The model was built from a hospital perspective, and included drug costs of L-AMB and ABLC, and costs for treating drug-related AEs (i.e. nephrotoxicity with/without dialysis, infusion-related reactions, anaphylaxis, hypomagnesaemia and hypokalaemia). Average sales price was used as the drug cost estimate in the base-case analyses. The treatment duration and rates of AEs for L-AMB and ABLC were mainly obtained from a retrospective study of these two drugs in the target population using the Cerner Health Facts data. Treatment costs of AEs were obtained from the publicly available sources. The budget impact (

Cost-Effectiveness Of Ceritinib In Previously Treated Patients With Crizotinib In Anaplastic Lymphoma Kinase-Positive (Alk+) Non-Small Cell Lung Cancer In Canada.

US, year 2011 values) was evaluated for a hypothetical hospital with 100 administrations where L-AMB and ABLC are used for the treatment of the target population by changing the market share of L-AMB and ABLC from 32/68xa0% to an anticipated market share of 60/40xa0% in the base-case analysis. Sensitivity analyses were conducted by varying drug costs, rates of AEs, costs of AEs and anticipated market shares of L-AMB and ABLC.ResultsThe estimated per-patient cost per hospital episode associated with L-AMB and ABLC use were

Cost-effectiveness of ceritinib in previously untreated anaplastic lymphoma kinase-positive metastatic non-small cell lung cancer in the United States

US14,563 and

Comparative Efficacy of Treatments for Previously Treated Advanced or Metastatic Non-Small-Cell Lung Cancer: A Network Meta-Analysis

US16,748, respectively. Cost of AEs accounted for 68.7xa0% of the costs for L-AMB and 85.4xa0% for ABLC. In a hypothetical hospital with 100 annual admissions of patients using these two drugs for IFIs, changing the market shares from 32/68xa0% for L-AMB and ABLC, respectively, to 60/40xa0% yielded a 3.8xa0% cost reduction, which corresponded to an absolute cost savings of

Economic impact of next generation sequencing vs sequential single-gene testing modalities to detect genomic alterations in metastatic non-small cell lung cancer using a decision analytic model.

US61,191. Sensitivity analyses indicated that the results were robust to changes in input parameter values in most cases.ConclusionsThis study suggests that hospitals can realize cost savings by substituting L-AMB for ABLC in the treatment of IFIs. The cost savings are driven by the lower rates of AEs associated with L-AMB use compared with ABLC.

Comprehensive investigation of adverse event (AE)-related costs in patients with metastatic breast cancer (MBC) treated with first- and second-line chemotherapies.

Abstract Background: To assess the cost-effectiveness of ceritinib vs alternatives in patients who discontinue treatment with crizotinib in anaplastic lymphoma kinase-positive (ALK+) non-small cell lung cancer (NSCLC) from a Canadian public healthcare perspective. Methods: A partitioned survival model with three health states (stable, progressive, and death) was developed. Comparators were chosen based on reported utilization from a retrospective Canadian chart study; comparators were pemetrexed, best supportive care (BSC), and historical control (HC). HC comprised of all treatment alternatives reported. Progression-free survival and overall survival for ceritinib were estimated using data reported from single-arm clinical trials (ASCEND-1 [NCT01283516] and ASCEND-2 [NCT01685060]). Survival data for comparators were obtained from published clinical trials in a NSCLC population and from a Canadian retrospective chart study. Parametric models were used to extrapolate outcomes beyond the trial period. Drug acquisition, administration, resource use, and adverse event (AE) costs were obtained from databases. Utilities for health states and disutilities for AEs based on EQ-5D were derived from literature. Incremental costs per quality-adjusted life year (QALY) gained were estimated. Univariate and probabilistic sensitivity analyses were performed. Results: Over 4 years, ceritinib was associated with 0.86 QALYs and total direct costs of

Budget Impact Analysis Of Liposomal Amphotericin B And Amphotericin B Lipid Complex For Treating Invasive Fungal Infections In Hospitalized Patients

89,740 for the post-ALK population. The incremental cost-effectiveness ratio (ICER) was