Out-of-pocket costs analysis of ifosfamide, epirubicin, and etoposide (IEV) and etoposide, solu-medrol-methylprednisolone, high-dose ara-C-cytarabine, and platinol-cisplatin (ESHAP) regimens in the patients with relapsed and refractory lymphoma in Iran (original) (raw)
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Iranian Journal of Cancer Prevention, 2015
Background: Chemotherapy for lymph nodes cancer is often composed of several drugs that are used in a treatment program. Objectives: The aim of this study was to perform a cost-utility analysis of IEV regimen (ifosfamide, epirubicin and etoposide) versus ESHAP regimen (etoposide, methylprednisolone, high-dose cytarabine, and cisplatin) in patients with lymphoma in the south of Iran. Patients and Methods: This was a cost-utility analysis done as a cross-sectional study in the south of Iran. Using decision tree, expected costs, quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) were estimated. In addition, the robustness of results was examined by sensitivity analysis. Results: The results of this study indicated that the total lymphoma patients were about 65 people that 27 patients received IEV regimen and 38 patients ESHAP (43 patients with Hodgkin's and 22 with non-Hodgkin lymphoma). The results of decision tree showed that in the IEV arm, the expected cost was 20952.93andtheexpectedQALYswas3.89andintheESHAParm,theexpectedcostwas20952.93 and the expected QALYs was 3.89 and in the ESHAP arm, the expected cost was 20952.93andtheexpectedQALYswas3.89andintheESHAParm,theexpectedcostwas31691.74 and the expected QALYs was 3.86. Based on the results of the study, IEV regimen was cost-effective alternative to the ESHAP regimen. Conclusions: According to the results of this study, it is recommended that oncologists use IEV instead of ESHAP in the treatment of patients with lymphoma and because of high costs of IEV drug costs, it is suggested that IEV drugs should be covered by insurance.
Haematologica, 2002
Few economic data exist on the treatment of indolent non-Hodgkin's lymphoma (NHL) and there are none in the published literature concerning relapsed disease. This international analysis (Canada, Germany, Italy) was established to estimate the overall direct cost of treating patients with relapsed indolent NHL and determine the main cost components of treatment. Telephone interviews were used to identify the most commonly used treatment regimens in each country. CHOP, CVP and fludarabine were chosen for economic analysis, which was based on retrospective data from 424 patients. Overall treatment costs for a course of six cycles varied more than 5-fold, from 3,445 to 17,940 Euros between regimens and countries. The treatment setting had a major impact on costs, with in-patient costs being up to three times greater than the equivalent out-patient values. Drug administration costs comprised 46-60% of the overall treatment costs in the in-patient setting. Adverse event management was...
Chemotherapy, 2016
The aim of this study was to perform cost-effectiveness Analysis of IEV versus ESHAP chemotherapy regimen in patients with Lymphoma in Iran. Our study used a cross-sectional design done as a double-blind study of 65 patients suffering from relapsed/refractory Hodgkin and non-Hodgkin's Lymphoma in Amir Oncology Hospital in Shiraz, in the south of Iran. The costs were included medical and non-medical direct costs and indirect costs. Effectiveness was reported in patient records and it was categorized into complete response, partial response and non-response The direct cost in IEV and ESHAP regimens 32159.87 and 69,143.72 respectively. In IEV arm, 53% of the patients with Hodgkin Lymphoma achieved complete response (CRs) and 35% a partial response (PRs). The overall response rate (CRs & PRs) was 88.2%. But in ESHAP arm, the overall response rate was 69.2%, 43.3% of patients achieved a complete response and 27% a partial response. The results showed that IEV versus ESHAP was dominant in the treatment of patients with lymphoma. Also, ICER
2015
Background: Chemotherapy for lymph nodes cancer is often composed of several drugs that are used in a treatment program. Objectives: The aim of this study was to perform a cost-utility analysis of IEV regimen (ifosfamide, epirubicin and etoposide) versus ESHAP regimen (etoposide, methylprednisolone, high-dose cytarabine, and cisplatin) in patients with lymphoma in the south of Iran. Patients and Methods: This was a cost-utility analysis done as a cross-sectional study in the south of Iran. Using decision tree, expected costs, quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) were estimated. In addition, the robustness of results was examined by sensitivity analysis. Results: The results of this study indicated that the total lymphoma patients were about 65 people that 27 patients received IEV regimen and 38 patients ESHAP (43 patients with Hodgkin’s and 22 with non-Hodgkin lymphoma). The results of decision tree showed that in the IEV arm, the e...
Journal of the National Cancer Institute, 2015
The NCIC CTG LY.12 study showed that gemcitabine, dexamethasone, and cisplatin (GDP) were noninferior to dexamethasone, cytarabine, and cisplatin (DHAP) in patients with relapsed or refractory aggressive histology lymphoma prior to autologous stem cell transplantation. We conducted an economic evaluation from the perspective of the Canadian public healthcare system based on trial data. The primary outcome was an incremental cost utility analysis comparing costs and benefits associated with GDP vs DHAP. Resource utilization data were collected from 519 Canadian patients in the trial. Costs were presented in 2012 Canadian dollars and disaggregated to highlight the major cost drivers of care. Benefit was measured as quality-adjusted life-years (QALYs) based on utilities translated from prospectively collected quality-of-life data. All statistical tests were two-sided. The mean overall costs of treatment per patient in the GDP and DHAP arms were 19961(9519 961 (95% confidence interval (CI) = 19961(95...
Real-world costs of illness of Hodgkin and the main B-Cell Non-Hodgkin lymphomas in France
Journal of Medical Economics
Background: Lymphomas are costly diseases that suffer from a lack of detailed economic information, notably in a real-world setting. Decision-makers are increasing the search for Real-World Evidence (RWE) to assess the impact, in real-life, of healthcare management and to support their public decisions. Thus, we aimed to assess the real-world net costs of the active treatment phases of adult Hodgkin Lymphoma (HL), Follicular Lymphoma (FL) and Diffuse Large B Cell Lymphoma (DLBCL). Methods: We performed a retrospective cohort study using population-based data from a national representative sample of the French population covered by the health insurance system. Cost analysis was performed from the French health insurance perspective and took into account direct and sick leave compensation costs (e2,018). Healthcare costs were studied over the active treatment phase. We used multivariate modeling to adjust cost differences between lymphoma subtypes. Results: Analyses were performed on 224 lymphoma patients and 896 controls. The mean additional monthly costs due to HL, FL and DLBCL patients were respectively e5,188, e3,242 and e7,659 for the active treatment phase. The main additional cost driver was principally inpatient stay (hospitalization costs and costly cancer-related drugs), followed by outpatient medication and productivity loss. When adjusted, DLBCL remains significantly the most costly lymphoma subtype. Conclusion: This study provides an accurate assessment of the main lymphoma subtypes related cost with high magnitude of details in a real-world setting. We underline where potential cost saving could be realized via the use of biosimilar medication, and where lymphoma management could be improved with the early management of adverse events. KEY POINTS This is one of the first studies which assess the additional cost of lymphoma in Europe, according the main sub-types of lymphoma and with real-world database. The additional monthly cost due to HL, FL and DLBCL patients were respectively e5,188, e3,242 and e7,659 for the active treatment phase and the main additional cost driver was principally inpatient stay (i.e. hospitalization costs and additional inpatient medicines, notably rituximab), followed by outpatient medication and productivity loss. This study provides an accurate and detailed lymphoma subtype cost description and comparison which supply data for efficiency evaluations and will allow French health policy to improve lymphoma management.
Journal of Comparative Effectiveness Research, 2019
Aim: Diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) are common types of non-Hodgkin's lymphoma, and real-world evidence continues to be lacking for healthcare costs and utilization among DLBCL and FL patients. Our study aims to describe medical and pharmacy costs and health resource utilization and to characterize longitudinal treatment patterns among these patients. Methods: A retrospective observational study was performed among adult patients with DLBCL or FL using the US MarketScan (Truven) administrative claims data from 1 January 2007 to 31 December 2015. Diagnoses of DLBCL and FL were based upon ICD-9 codes. Identifications of treatment lines involved 30 lymphoma-specific anticancer systemic agents. Direct healthcare costs and utilizations were computed in the 1-year postdiagnosis period. Generalized linear models with a gamma link were used to compare healthcare costs between therapies with and without rituximab. Results: A total of 2767 DLBCL and 598...
Leukemia & Lymphoma, 2008
The addition of rituximab to cyclophosphamide, vincristine and prednisolone (CVP) for advanced follicular lymphoma increases median time to progression by 17 months. A US societal cost-effectiveness of R-CVP versus CVP is estimated for a representative 50-year-old patient. Progression-free survival (PFS) and overall survival are based on a randomized Phase III trial. Costs are estimated using Medicare reimbursement rates and published drug price data, and include drug and administration costs, adverse events, treatment of relapses, and end-of-life care. Utility estimates are derived from the literature and a 3% discount rate is employed. Mean overall survival is projected to be 1.51 years longer for patients assigned to R-CVP versus CVP. The cost per quality-adjusted year of life gained is $28,565. The utility associated with stable or progressive disease and the unit drug cost of rituximab most influence the findings. The cost-effectiveness ratio of R-CVP compared with CVP is projected to be cost-effective in the United States under a range of sensitivity analyses.