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Direct medical costs of treatment in newly-diagnosed high-grade glioma among commercially insured US patients
Aim
This analysis assessed the direct medical costs of newly-diagnosed, temozolomide (TMZ)-treated glioblastoma (GBM) from the perspective of a US commercial setting.
Materials and methods
The analysis included subjects identified from the IMS PharMetrics LifeLink Plus™ claims database from January 1, 2008 to August 31, 2014 who were ?18 years of age, had ?1 malignant brain cancer diagnosis, had brain surgery ?90 days prior to TMZ initiation, had TMZ treatment, and were continuously enrolled for ?12 months pre-diagnosis and ?1 month post-diagnosis. Per-patient per-month (PPPM) and cumulative costs from 3 months pre-diagnosis to various post-diagnosis follow-up time points were calculated. Multivariable analyses were used to estimate adjusted mean cost and identify contributors of cost.
Results
The study included 2,921 subjects (median age?=?56 years; 60% male). After diagnosis, the median (interquartile range, IQR) number of inpatient, emergency department, and outpatient visits were 2 (1-4), 1 (1-3), and 19 (13-27); median (IQR) length of stay per hospitalization was 5 (3-9) days. Mean total cumulative costs per patient from 3 months pre-diagnosis to 12 months and to 5 years post-diagnosis were $201,749 (197,490-206,024) and $268,031 (262,877-274,416). Mean (SD) PPPM costs were $818 (1,128) and $7,394 (8,676) pre- and post-GBM diagnosis, respectively. The variables most predictive of cumulative costs included radiation therapy (+$81,732), ?2 weeks of hospitalization (+$49,629), and ?7 MRI scans (+$40,105).
Conclusion
The direct medical costs of newly-diagnosed, TMZ-treated GBM in commercially insured patients are substantial, with estimated total cumulative costs of $268,031.
Authors
S Jiang, K Hill, D Patel, A R Waldeck, M Botteman, A Aly, A D Norden
Journal
Journal of medical economics
Therapeutic Area
Oncology
Center of Excellence
Health Economic Modeling & Meta-analysis
Year
2017
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