TITLE:
Treatment Patterns and Healthcare Costs among U.S. Patients with Advanced Melanoma Initiating Subsequent Systemic Therapy Following Use of Ipilimumab (IPI)
AUTHORS:
Elisabetta Malangone-Monaco, Tony Okoro, Beata Korytowsky, Amy Stanford, Stephen Johnston, William Johnson, Sigrun Hallmeyer
KEYWORDS:
Healthcare Costs, Ipilimumab, Melanoma, Treatment Patterns
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.7 No.5,
May
11,
2016
ABSTRACT: As the treatment landscape for advanced melanoma continues to evolve, it
is critical to focus on unmet needs and understand the cost of therapy. While Ipilimumab
(IPI), an immunotherapy indicated for unresectable advanced melanoma, has been
a mainstay of 1st-line treatment, there was no standard of care
following progression until recently. The objective of this study was to examine
real-world treatment patterns and healthcare costs following IPI use in
advanced melanoma patients prior to the anti-PD-1 class approval. Adult stage
III or IV melanoma patients treated with IPI were selected between April 1,
2011, and September 30, 2013, from a large U.S. commercial and Medicare claims
database. Patients were evaluated for therapy after IPI, with an index date set
as the first systemic therapy after IPI. Per-Patient Per-Month (PPPM)
healthcare costs while on active treatment were evaluated from index until
treatment discontinuation, inpatient death, end of insurance enrollment, or
September 30, 2013. Of 361 eligible patients, 111 (30.7%) initiated subsequent
systemic therapy (mean age, 57 years; 64.9% male). The most common therapies,
single-agent or combination, included vemurafenib (32.4%), paclitaxel (28.8%),
temozolomide (20.7%), and carboplatin (17.1%). During a median follow-up of 130
days, mean [standard deviation] PPPM all-cause total healthcare costs were
$20,383 [$18,988], of which $4800 (23.6%), $5899 (28.9%), and $9684 (47.5%)
were related to melanoma drug costs, medical claims with a diagnosis of melanoma,
and other (non-specified) utilization, respectively. When considering total
care, the costs of U.S. patients with advanced melanoma post-IPI were
substantial across all commonly used agents.