PMID- 30647822
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231005
IS  - 1942-2962 (Print)
IS  - 1942-2970 (Electronic)
IS  - 1942-2962 (Linking)
VI  - 11
IP  - 7
DP  - 2018 Oct
TI  - Economic Burden of Adverse Events Associated with Immunotherapy and Targeted 
      Therapy for Metastatic Melanoma in the Elderly.
PG  - 334-343
AB  - BACKGROUND: Immunotherapies and targeted therapies have drastically improved 
      survival in metastatic melanoma, but they can cause a range of adverse events 
      (AEs). Understanding the costs of these events would facilitate an accurate 
      comparison of melanoma treatments. OBJECTIVE: To compare the costs and frequency 
      of AEs associated with immunotherapy and with targeted therapy in elderly 
      patients with metastatic melanoma. METHODS: We conducted a retrospective cohort 
      study using Medicare claims data from 2011 to 2014. Patients included had to have 
      >/=1 diagnoses of metastatic melanoma and >/=1 claims for an immunotherapy or 
      targeted therapy. We compared the 30-day expenditures of patients with and 
      without each AE using a generalized linear model to determine the incremental 
      cost per AE in patients who received immunotherapy or targeted therapy. The 
      baseline demographic and clinical differences were adjusted for using propensity 
      score with inverse probability of treatment. We also compared the mean costs of 
      AEs associated with immunotherapy and targeted therapy. RESULTS: A total of 844 
      patients were included in the study (mean age, 75 years; standard deviation, 14 
      years). The mean baseline Charlson Comorbidity Index score was 8.4, and 65% of 
      the patients were male. The mean cost for AEs was highest for respiratory events 
      (ie, $24,150). Gastrointestinal, respiratory, and hematologic AEs were more 
      common in patients who received immunotherapy, whereas general and 
      administration-site AEs and other AEs (eg, fatigue, infections, muscular 
      weakness) were more frequent in patients who received targeted therapy. 
      AE-related costs with immunotherapy were highest for gastrointestinal, 
      respiratory, and pain-related AEs; AEs with targeted therapy were highest for 
      cardiovascular and general and administration-site events. CONCLUSION: These 
      findings suggest that incremental costs associated with treatment-related AEs 
      among elderly patients with metastatic melanoma were substantial, but the risks 
      for and costs of the various types of AEs differed by therapy. Understanding the 
      risks for and costs of AEs associated with the various therapeutic options can 
      inform treatment decision-making in elderly patients with metastatic melanoma.
FAU - Ghate, Sameer R
AU  - Ghate SR
AD  - Director, Health Economics and Outcomes Research, Novartis Oncology, East 
      Hanover, NJ.
FAU - Li, Zhiyi
AU  - Li Z
AD  - Partner, Asclepius Analytics, New York, NY.
FAU - Tang, Jackson
AU  - Tang J
AD  - Partner, Asclepius Analytics, New York, NY.
FAU - Nakasato, Antonio Reis
AU  - Nakasato AR
AD  - Medical Director, Novartis Oncology.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Health Drug Benefits
JT  - American health & drug benefits
JID - 101479877
PMC - PMC6306100
OTO - NOTNLM
OT  - adverse events
OT  - economic burden
OT  - elderly patients
OT  - immunotherapy
OT  - metastatic melanoma
OT  - targeted therapy
OT  - treatment-related costs
EDAT- 2019/01/17 06:00
MHDA- 2019/01/17 06:01
PMCR- 2018/10/01
CRDT- 2019/01/17 06:00
PHST- 2019/01/17 06:00 [entrez]
PHST- 2019/01/17 06:00 [pubmed]
PHST- 2019/01/17 06:01 [medline]
PHST- 2018/10/01 00:00 [pmc-release]
PST - ppublish
SO  - Am Health Drug Benefits. 2018 Oct;11(7):334-343.