Hackshaw Michelle D, Krishna Arun, Mauro David J
Global Health Outcomes, Merck, Sharpe and Dohme Corporation, Whitehouse Station, NJ, USA.
Clinicoecon Outcomes Res. 2012;4:169-76. doi: 10.2147/CEOR.S32349. Epub 2012 Jun 18.
The purpose of this study was to identify a real-world US population having undergone surgery for malignant melanoma and describe treatment patterns, health care resource utilization, and costs for patients who subsequently received interferon alfa-2b (IFN) therapy or other standard of care chemotherapies.
A retrospective cohort study was conducted using administrative claims from MarketScan(®) databases among melanoma patients diagnosed between 2004 and 2008 who had surgery and were subsequently treated with IFN or other chemotherapies. Health care resource utilization and costs of services (converted to 2009 dollars) were evaluated. Cost refers to the amount paid to providers associated with the health service.
Of 18,075 subjects with melanoma surgery claims, 1525 (8.4%) were treated with IFN and 1194 (6.6%) with other chemotherapies. Median duration (days) and number of doses of IFN therapy were 29 and 20, respectively. Approximately half of patients who received IFN discontinued therapy within or after the one-month induction phase. For IFN therapy patients, average total cost per patient for the last melanoma-related surgery prior to start of therapy, including costs of the surgery itself, pathology, anesthesia, and hospital care, was $2219. The average total cost per patient related to IFN therapy was $1188; this included costs for drug, office visits, blood work, and infusions. Other chemotherapy costs ranged from $146 to $2678.
There is an unmet treatment need, considering that this study observed that melanoma patients on IFN therapy post-surgery do not complete the recommended one-year course of treatment which may compromise its full therapeutic benefits. Further study to investigate reasons for discontinuation may be warranted. In addition, costs associated with adjuvant IFN therapy in post-surgical treatment of disease are likely acceptable.
本研究的目的是确定接受过恶性黑色素瘤手术的真实美国人群,并描述随后接受干扰素α-2b(IFN)治疗或其他标准护理化疗的患者的治疗模式、医疗资源利用情况和费用。
使用MarketScan®数据库中的管理索赔数据进行一项回顾性队列研究,研究对象为2004年至2008年期间被诊断为黑色素瘤且接受了手术,随后接受IFN或其他化疗的患者。评估了医疗资源利用情况和服务费用(换算为2009年美元)。费用指与医疗服务相关支付给提供者的金额。
在18075例有黑色素瘤手术索赔的受试者中,1525例(8.4%)接受了IFN治疗,1194例(6.6%)接受了其他化疗。IFN治疗的中位持续时间(天)和剂量数分别为29天和20剂。接受IFN治疗的患者中约有一半在1个月诱导期内或之后停止治疗。对于接受IFN治疗的患者,在治疗开始前最后一次与黑色素瘤相关手术的平均每位患者总费用,包括手术本身、病理、麻醉和医院护理费用,为2219美元。与IFN治疗相关的平均每位患者总费用为1188美元;这包括药物、门诊、血液检查和输液费用。其他化疗费用从146美元到2678美元不等。
考虑到本研究观察到术后接受IFN治疗的黑色素瘤患者未完成推荐的一年疗程,这可能会影响其全部治疗益处,因此存在未满足的治疗需求。可能有必要进一步研究停药原因。此外,疾病术后辅助IFN治疗相关的费用可能是可以接受的。