PMID- 30895832
OWN - NLM
STAT- MEDLINE
DCOM- 20200102
LR  - 20200102
IS  - 1941-837X (Electronic)
IS  - 1369-6998 (Linking)
VI  - 22
IP  - 7
DP  - 2019 Jul
TI  - Economic burden of chemotherapy-treated recurrent and/or metastatic squamous cell 
      carcinoma of the head and neck in France: real-world data from the permanent 
      sample of national health insurance beneficiaries.
PG  - 698-705
LID - 10.1080/13696998.2019.1594837 [doi]
AB  - Aims: Overall survival (OS) of patients with recurrent or metastatic (R/M) 
      squamous cell carcinoma of the head and neck (SCCHN) is extremely poor. New 
      therapeutic options emerge but need to establish their economic value. The 
      objective was to describe the direct and related costs of R/M SCCHN in France. 
      Materials and methods: We selected all adult patients treated with chemotherapy 
      for R/M SCCHN between 1 January 2009 and 31 December 2014 from the permanent 
      sample of the French national health insurance database (EGB). Data were analyzed 
      from the index date (first chemotherapy) until patients' death or 31 December 
      2015. "Treatment period" and "end-of-life" (EoL) (from last chemotherapy until 
      death) were distinguished. Costs included all hospitalizations for SCCHN and 
      ambulatory care. Costs of hospitalized and non-hospitalized adverse events (AEs) 
      were estimated. Results: Among 267 patients identified, 85% were men, 44% had 
      metastases at the index date and the mean age was 62.0 years (+/-9.9). The most 
      common tumor location was oropharynx (29%) but 39% of patients had multiple 
      locations. Median OS was 9.3 (95% CI: 7.9-11.8) months for the overall 
      population. The average total direct cost per patient was euro49,954, broken down 
      into euro32,908 (95% CI: 29,525-36,290) for hospitalizations and euro17,047 
      (14,941-19,152) for ambulatory care. Main cost drivers were drug acquisition and 
      administration (euro14,538) during the treatment period (209 days on average) and 
      palliative care (euro3,750) during the EoL period (125 days). Regarding related 
      costs, around 12% of patients received disability pensions (euro1,397 per patient 
      [624-2,171]) and sick leave payments (euro1,592 [888-2,297]). "Metabolism and 
      nutrition disorders" and "Infections and infestations" were the most expensive 
      hospitalized AEs (euro1,513 and euro1,180 per patient, respectively). Febrile 
      neutropenia was the most expensive non-hospitalized AE (euro766 per patient). 
      Conclusions: This analysis of real-world data confirms the poor prognosis of 
      patients with R/M SCCHN and provides cost data for future economic evaluations.
FAU - Lafuma, Antoine
AU  - Lafuma A
AD  - a Cemka , Bourg-la-Reine , France.
FAU - Cotte, Francois-Emery
AU  - Cotte FE
AD  - b Health Economics & Outcomes Research , Bristol-Myers Squibb , Rueil-Malmaison , 
      France.
FAU - Le Tourneau, Christophe
AU  - Le Tourneau C
AD  - c Department of Drug Development and Innovation (D3i) , Paris & Saint-Cloud , 
      France.
AD  - d INSERM U900 Research Unit , Saint-Cloud , France.
AD  - e Paris-Saclay University , France.
FAU - Emery, Corinne
AU  - Emery C
AD  - a Cemka , Bourg-la-Reine , France.
FAU - Gaudin, Anne-Francoise
AU  - Gaudin AF
AD  - b Health Economics & Outcomes Research , Bristol-Myers Squibb , Rueil-Malmaison , 
      France.
FAU - Torreton, Elodie
AU  - Torreton E
AD  - a Cemka , Bourg-la-Reine , France.
FAU - Gourmelen, Julie
AU  - Gourmelen J
AD  - f UMS 011, UVSQ, INSERM , Villejuif , France.
FAU - Bonastre, Julia
AU  - Bonastre J
AD  - g Gustave Roussy, Universite Paris-Saclay, Service de Biostatistique et 
      d'Epidemiologie , Villejuif , France.
AD  - h INSERM U1018, CESP, Universite Paris-Sud, Universite Paris-Saclay , Villejuif , 
      France.
LA  - eng
PT  - Journal Article
DEP - 20190402
PL  - England
TA  - J Med Econ
JT  - Journal of medical economics
JID - 9892255
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Combined Chemotherapy Protocols/*economics/therapeutic use
MH  - Cohort Studies
MH  - Cost of Illness
MH  - Cost-Benefit Analysis
MH  - Databases, Factual
MH  - Female
MH  - France
MH  - Head and Neck Neoplasms/*drug therapy/*economics/mortality/pathology
MH  - *Health Care Costs
MH  - Humans
MH  - Insurance Claim Review
MH  - Male
MH  - Middle Aged
MH  - National Health Programs/economics/statistics & numerical data
MH  - Neoplasm Metastasis
MH  - Neoplasm Recurrence, Local/*drug therapy/economics/pathology
MH  - Retrospective Studies
MH  - Sampling Studies
MH  - Squamous Cell Carcinoma of Head and Neck/*drug 
      therapy/economics/mortality/pathology
MH  - Survival Analysis
OTO - NOTNLM
OT  - France
OT  - Head and neck cancer
OT  - adverse events
OT  - chemotherapy
OT  - economic burden
OT  - end-of-life
OT  - real-world data
EDAT- 2019/03/22 06:00
MHDA- 2020/01/03 06:00
CRDT- 2019/03/22 06:00
PHST- 2019/03/22 06:00 [pubmed]
PHST- 2020/01/03 06:00 [medline]
PHST- 2019/03/22 06:00 [entrez]
AID - 10.1080/13696998.2019.1594837 [doi]
PST - ppublish
SO  - J Med Econ. 2019 Jul;22(7):698-705. doi: 10.1080/13696998.2019.1594837. Epub 2019 
      Apr 2.