scholarly journals Impact on Medical Cost, Cumulative Survival, and Cost-Effectiveness of Adding Rituximab to First-Line Chemotherapy for Follicular Lymphoma in Elderly Patients: An Observational Cohort Study Based on SEER-Medicare

2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
Robert I. Griffiths ◽  
Michelle L. Gleeson ◽  
Joseph Mikhael ◽  
Mark D. Danese
Keyword(s):  
Cost Effectiveness ◽  
Elderly Patients ◽  
Follicular Lymphoma ◽  
The Elderly ◽  
Medical Costs ◽  
Routine Practice ◽  
First Line ◽  
Cumulative Survival ◽  
Direct Medical Costs ◽  
Line Chemotherapy

Rituximab improves survival in follicular lymphoma (FL), but is considerably more expensive than conventional chemotherapy. We estimated the total direct medical costs, cumulative survival, and cost-effectiveness of adding rituximab to first-line chemotherapy for FL, based on a single source of data representing routine practice in the elderly. Using surveillance, epidemiology, and end results (SEER) registry data plus Medicare claims, we identified 1,117 FL patients who received first-line CHOP (cyclophosphamide (C), doxorubicin, vincristine (V), and prednisone (P)) or CVP +/−rituximab. Multivariate regression was used to estimate adjusted cumulative cost and survival differences between the two groups over four years after beginning treatment. The median age was 73 years (minimum 66 years), 56% had stage III-IV disease, and 67% received rituximab. Adding rituximab to first-line chemotherapy was associated with higher adjusted incremental total cost ($18,695; 95% Confidence Interval (CI) $9,302–$28,643) and longer adjusted cumulative survival (0.18 years; 95% CI 0.10–0.27) over four years of followup. The expected cost-effectiveness was $102,142 (95% CI $34,531–296,337) per life-year gained. In routine clinical practice, adding rituximab to first-line chemotherapy for elderly patients with FL results in higher direct medical costs to Medicare and longer cumulative survival after four years.

scholarly journals COST-EFFECTIVENESS ANALYSIS ON THE USE OF PARENTERAL NUTRITION WITH D10-CA GLUCONATE AND D5 1/4NS IN NORMAL-WEIGHT NEONATES WITH RESPIRATORY DISTRESS SYNDROME

2017 ◽  
Vol 9 ◽  
pp. 63
Author(s):  
Fitria Ningsih ◽  
Rani Sauriasari ◽  
Agusdini Banun Saptaningsih
Keyword(s):  
Cost Effectiveness ◽  
Parenteral Nutrition ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Medical Costs ◽  
Pulse Frequency ◽  
Normal Weight ◽  
Average Weight ◽  
Direct Medical Costs

Objectives: This retrospective cohort study aimed to compare the cost-effectiveness of using D10-CaGluconate and D5 1/4NS preparations in normalweightneonatal patients with Respiratory Distress Syndrome (RDS) in Kambang General Hospital, Jambi, Indonesia.Methods: The research was conducted from September 2014 to June 2015. The study participants were divided into two groups; D10-CaGluconatewas administered to 40 patients and D5 1/4NS to 43 patients. Effectiveness was assessed based on the changes in the physical examination results,average weight gain (28.48 and 23.49 g/day), blood glucose levels (26.73 and 26.42 mg/dL), respiratory rate (−12.35 breaths/minute and −7.77breaths/minute), pulse frequency (−10.98 and −8.07 ±), and body temperature (0.013°C and 0.012°C) of the patients in the D10-CaGluconate andD5 1/4NS groups, respectively.Results: The average direct medical costs of using D10-CaGluconate and D5 1/4NS were 458,290 IDR and 408,347 IDR, respectively. The average costeffectivenessratio value of total direct medical costs for D10-CaGluconate preparation was 35,207,467 IDR while that for D5 1/4NS was 33,958,602IDR. The direct medical cost of the incremental cost-effectiveness ratio mean value of the D5 1/4NS preparation that compared to the D10-CaGluconatepreparation was 10,017,210 IDR.Conclusions: The parenteral nutrition preparation of D10-CaGluconate is more cost-effective than that of D5 1/4NS.

Medical Costs and Outcomes for Australian Women With Ovarian Cancer: A Patient-Level Analysis Over 2.5 Years

2010 ◽  
Vol 20 (5) ◽  
pp. 757-765 ◽  
Author(s):  
Louisa G. Gordon ◽  
Paul A. Scuffham ◽  
Vanessa L. Beesley ◽  
Adèle C. Green ◽  
Anna DeFazio ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Adverse Effects ◽  
Medical Costs ◽  
Stage I ◽  
Disease Stage ◽  
Quality Adjusted Life Years ◽  
First Line ◽  
Direct Medical Costs ◽  
Life Years ◽  
Quality Adjusted Life

Objective:As treatment costs for gynecological cancer escalate, real-world data on use of resources and costs becomes increasingly important. This study investigated medical costs, quality of life, and survival end points for women with ovarian cancer in Australia.Methods:Women with primary epithelial ovarian cancer referred for chemotherapy (n = 85) were recruited through 7 hospitals in Australia. Overall survival, progression-free interval, and quality-adjusted life years were assessed by stage using the Cox proportional hazards models. Direct medical costs, including those for surgeries, hospitalizations, supportive care, chemotherapy, and adverse effects (while on chemotherapy), were calculated over 2.5 years and assessed by nonparametric bootstrapping.Results:Quality-adjusted life years decreased with increased disease stage at diagnosis and ranged from 2.3 for women with stage I or II disease to 1.3 for those with stage IV disease. A total of AU $4.1 million (2008) were spent on direct medical costs for 85 women over approximately 2.5 years. Medical costs were significantly higher for women with stage III or IV disease compared with that for women with stage I or II disease ($50,945 vs $31,958,P< 0.01) and/or women who experienced surgical complications and/or adverse effects requiring hospitalization while on chemotherapy ($57,821 vs $34,781,P< 0.01). Costs after first-line chemotherapy were significantly higher for women with advanced disease (mean, $20,744) compared with those for women with early disease (mean, $5525;P< 0.01).Conclusions:Whereas for women with early-stage ovarian cancer, costs are concentrated in the period of primary treatment, cumulated costs are especially high for women with recurrent disease rising rapidly after first-line therapy.

scholarly journals Quality of life of patients with metastatic pancreatic adenocarcinoma initiating first-line chemotherapy in routine practice

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Berta Laquente ◽  
Teresa Macarulla ◽  
Cristina Bugés ◽  
Marta Martín ◽  
Carlos García ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pancreatic Adenocarcinoma ◽  
Routine Practice ◽  
First Line ◽  
Metastatic Pancreatic Adenocarcinoma ◽  
Line Chemotherapy

scholarly journals Efficacy and Feasibility of Modified Folfox as First-Line Chemotherapy in Elderly Patients with Metastatic or Recurrent Gastric Cancer

2013 ◽  
Vol 24 ◽  
pp. iv60
Author(s):  
Kyu-Hyoung Lim ◽  
Sang Hoon Lee ◽  
Hui-Young Lee ◽  
Sung Bae Park ◽  
Seo-Young Song
Keyword(s):  
Gastric Cancer ◽  
Elderly Patients ◽  
First Line ◽  
Recurrent Gastric Cancer ◽  
Line Chemotherapy
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