PMID- 29278014
OWN - NLM
STAT- MEDLINE
DCOM- 20180925
LR  - 20181202
IS  - 1941-837X (Electronic)
IS  - 1369-6998 (Linking)
VI  - 21
IP  - 5
DP  - 2018 May
TI  - Healthcare resource utilization among patients with relapsed multiple myeloma in 
      the UK, France, and Italy.
PG  - 450-467
LID - 10.1080/13696998.2017.1421546 [doi]
AB  - AIMS: To assess the real-world healthcare resource utilization (HRU) and costs 
      associated with different treatment regimens used in the management of patients 
      with relapsed multiple myeloma in the UK, France, and Italy. METHODS: 
      Retrospective medical chart review of characteristics, time to progression, level 
      of response, HRU during treatment, and adverse events (AEs). Data collection 
      started on June 1, 2015 and was completed on July 15, 2015. In the 3 months 
      before record abstraction, eligible patients had either disease progression after 
      receiving one of their country's most commonly prescribed regimens or had 
      received the best supportive care and died. Costs were calculated based on HRU 
      and country-specific diagnosis-related group and/or unit reference costs, amongst 
      other standard resources. RESULTS: Physicians provided data for 1,282 patients 
      (387 in the UK, 502 in France, 393 in Italy) who met the inclusion criteria. Mean 
      [median] total healthcare costs associated with a single line of treatment were 
      euro51,717 [35,951] in the UK, euro37,009 [32,538] for France, and euro34,496 [42,342] for 
      Italy, driven largely by anti-myeloma medications costs (contributing 95.0%, 
      90.0%, and 94.2% of total cost, respectively). During active treatment, the 
      highest costs were associated with lenalidomide- and pomalidomide-based regimens. 
      Mean cost per month was lowest for patients achieving a very good partial 
      response or better. Unscheduled events (i.e. not considered part of routine 
      management, whether or not related to multiple myeloma, such as unscheduled 
      hospitalization, AEs, fractures) accounted for 1-9% of total costs and were 
      highest for bendamustine. LIMITATIONS: The use of retrospective data means that 
      clinical practice (e.g. use of medical procedures, evaluation of treatment 
      response) is not standardized across participating countries/centers, and some 
      data (e.g. low-grade AEs) may be incomplete or differently adjudicated/reported. 
      The centers involved may not be fully representative of national practice. 
      CONCLUSIONS: Drug costs are the main contributor to total HRU costs associated 
      with multiple myeloma. The duration of active treatment may influence the average 
      total costs, as well as response, associated with a single line of therapy. 
      Improved treatment outcomes, and reductions in unscheduled events and concomitant 
      medication use may, therefore, reduce the overall HRU and related costs of care 
      in multiple myeloma.
FAU - Gonzalez-McQuire, Sebastian
AU  - Gonzalez-McQuire S
AD  - a Amgen (Europe) GmbH , Zug , Switzerland.
FAU - Yong, Kwee
AU  - Yong K
AD  - b Department of Haematology , University College London , London , UK.
FAU - Leleu, Henri
AU  - Leleu H
AD  - c Public Health Expertise , Paris , France.
FAU - Mennini, Francesco S
AU  - Mennini FS
AD  - d Faculty of Economics, Economic Evaluation and HTA, Centre for Economic and 
      International Studies , University of Rome Tor Vergata , Rome , Italy.
AD  - e Institute for Leadership and Management in Health, Kingston University , Surrey 
      , UK.
FAU - Flinois, Alain
AU  - Flinois A
AD  - f Kantar Health , Paris , France.
FAU - Gazzola, Carlotta
AU  - Gazzola C
AD  - f Kantar Health , Paris , France.
FAU - Schoen, Paul
AU  - Schoen P
AD  - a Amgen (Europe) GmbH , Zug , Switzerland.
FAU - Campioni, Marco
AU  - Campioni M
AD  - a Amgen (Europe) GmbH , Zug , Switzerland.
FAU - DeCosta, Lucy
AU  - DeCosta L
AD  - g Amgen Ltd , Uxbridge , UK.
FAU - Fink, Leah
AU  - Fink L
AD  - f Kantar Health , Paris , France.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20180110
PL  - England
TA  - J Med Econ
JT  - Journal of medical economics
JID - 9892255
RN  - 4Z8R6ORS6L (Thalidomide)
RN  - 981Y8SX18M (Bendamustine Hydrochloride)
RN  - D2UX06XLB5 (pomalidomide)
RN  - F0P408N6V4 (Lenalidomide)
SB  - IM
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/administration & dosage/adverse 
      effects/*economics/*therapeutic use
MH  - Bendamustine Hydrochloride/economics
MH  - Disease Progression
MH  - Female
MH  - France
MH  - Health Expenditures/statistics & numerical data
MH  - Health Resources/*statistics & numerical data
MH  - Hospitalization/economics
MH  - Humans
MH  - Italy
MH  - Lenalidomide
MH  - Male
MH  - Middle Aged
MH  - Models, Econometric
MH  - Multiple Myeloma/*drug therapy/*economics
MH  - Retrospective Studies
MH  - Thalidomide/analogs & derivatives/economics
MH  - United Kingdom
OTO - NOTNLM
OT  - HRU
OT  - Healthcare resource utilization
OT  - costs
OT  - real-world
OT  - relapsed multiple myeloma
EDAT- 2017/12/27 06:00
MHDA- 2018/09/27 06:00
CRDT- 2017/12/27 06:00
PHST- 2017/12/27 06:00 [pubmed]
PHST- 2018/09/27 06:00 [medline]
PHST- 2017/12/27 06:00 [entrez]
AID - 10.1080/13696998.2017.1421546 [doi]
PST - ppublish
SO  - J Med Econ. 2018 May;21(5):450-467. doi: 10.1080/13696998.2017.1421546. Epub 2018 
      Jan 10.