Estimated Costs of the Ipilimumab-Nivolumab Therapy and Related Adverse Events in Metastatic Melanoma.

Détails

Ressource 1Télécharger: GautronMoura_Cancers_2023.pdf (1834.67 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_0AF72365A8C3
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Estimated Costs of the Ipilimumab-Nivolumab Therapy and Related Adverse Events in Metastatic Melanoma.
Périodique
Cancers
Auteur⸱e⸱s
Gautron Moura B., Gerard C.L., Testart N., Caikovski M., Wicky A., Aedo-Lopez V., Berthod G., Homicsko K., Prior J.O., Dromain C., Kandalaft L.E., Cuendet M.A., Michielin O.
ISSN
2072-6694 (Print)
ISSN-L
2072-6694
Statut éditorial
Publié
Date de publication
21/12/2022
Peer-reviewed
Oui
Volume
15
Numéro
1
Pages
31
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Combined ipilimumab and nivolumab significantly improve outcomes in metastatic melanoma patients but bear an important financial impact on the healthcare system. Here, we analyze the treatment costs, focusing on irAE. We conducted a retrospective analysis of 62 melanoma patients treated with ipilimumab-nivolumab at the Lausanne University Hospital between 1 June 2016 and 31 August 2019. The frequency of irAEs and outcomes were evaluated. All melanoma-specific costs were analyzed from the first ipilimumab-nivolumab dose until the therapy given subsequently or death. A total of 54/62 (87%) patients presented at least one irAE, and 31/62 (50%) presented a grade 3-4 irAE. The majority of patients who had a complete response 12/14 (86%) and 21/28 (75%) of overall responders presented a grade 3-4 toxicity, and there were no responses in patients without toxicity. Toxicity costs represented only 3% of the total expenses per patient. The most significant contributions were medication costs (44%) and disease costs (39%), mainly disease-related hospitalization costs, not toxicity-related. Patients with a complete response had the lowest global median cost per week of follow up (EUR 2425) and patients who had progressive disease (PD), the highest one (EUR 8325). Except for one patient who had a Grade 5 toxicity (EUR 6043/week), we observe that less severe toxicity grades (EUR 9383/week for Grade 1), or even the absence of toxicity (EUR 9922/week), are associated with higher median costs per week (vs. EUR 3266/week for Grade 4 and EUR 2850/week for Grade 3). The cost of toxicities was unexpectedly low compared to the total costs, especially medication costs. Patients with higher toxicity grades had better outcomes and lower total costs due to treatment discontinuation.
Mots-clé
costs, immune checkpoint inhibitors, immune-related adverse events, immunotherapy, ipilimumab, melanoma, nivolumab, toxicity
Pubmed
Web of science
Open Access
Oui
Création de la notice
17/01/2023 9:09
Dernière modification de la notice
23/01/2024 7:17
Données d'usage