Health care and socioeconomic costs for long-term survivors after implementation of checkpoint-inhibitors and targeted agents for metastatic melanoma

Anne Vest Soerensen; Jakob Kjellberg; Rikke Ibsen; Lars Bastholt; Henrik Schmidt; Inge Marie Svane

doi:10.1016/j.ejca.2023.113288

Health care and socioeconomic costs for long-term survivors after implementation of checkpoint-inhibitors and targeted agents for metastatic melanoma

Eur J Cancer. 2023 Oct:192:113288. doi: 10.1016/j.ejca.2023.113288. Epub 2023 Aug 19.

Authors

Anne Vest Soerensen¹, Jakob Kjellberg², Rikke Ibsen³, Lars Bastholt⁴, Henrik Schmidt⁵, Inge Marie Svane⁶

Affiliations

¹ Department of Oncology, Copenhagen University Hospital Herlev, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark. Electronic address: anne.vest.soerensen@regionh.dk.
² The Danish Center for Social Science Research (VIVE), Copenhagen, Herluf Trolles Gade 11, 1052 Copenhagen K, Denmark.
³ i2Minds, Klosterport 4E 4., 8000 Aarhus, Denmark.
⁴ Department of Oncology, Odense University Hospital, J.B. Winsloews vej 4, 5000 Odense C, Denmark.
⁵ Department of Oncology, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus, Denmark.
⁶ National Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev, Borgmester Ib Juuls Vej 25C, 2730 Herlev, Denmark.

PMID: 37672816
DOI: 10.1016/j.ejca.2023.113288

Abstract

Background: Real-life data on health care costs and loss of productivity after implementing new agents for metastatic melanoma are important to supplement model-based economic data.

Materials and methods: All patients registered in the Danish Metastatic Melanoma Database (DAMMED) and the National Patient Registry in 2007-2011 were compared to 2012-2016 after the implementation of checkpoint inhibitors and targeted therapy. Health care costs, social transfer income (STI), and loss of productivity were calculated with a 2-step one model generalised linear regression (GLM) model. Medicine costs were calculated separately.

Results: In 2007-2011, 70 (15%) out of 464 patients were long-term survivors compared to 347 (32%) out of 1089 patients in 2012-2016. Total health care costs per patient year were significantly lower in the first treatment year (€41.457 versus €60.547, relative change (RC) 0.72, 95% confidence interval (CI) 0.56-0.94, p = 0.015) and without significant difference the second year in 2012-2016 compared to 2007-2011. Medicine costs per patient year increased the first (€85.464 versus €26.339, RC 3.39, 95% CI 2.61-4.41, p < 0.001) and the second (€26.464 versus €11.150, RC 2.59, 95% CI 1.98-3.40, p < 0.001) year in 2012-2016 compared to 2007-2011. Productivity increased for long-term survivors in 2012-2016 in contrast to 2007-2011.

Conclusion: Implementation of targeted therapy and checkpoint-inhibitors has increased medicine costs more than three-fold for long-term survivors. Total health care costs excluding medicine costs were significantly lower for long-term survivors the first and without change the second treatment year in 2012-2016 compared to 2007-2011. However, the number of treated patients increased which leads to an increase in overall total health care costs. Importantly, productivity increased for long-term survivors in 2012-2016.

Keywords: Health economic analysis; Immune checkpoint-inhibitor; Long-term survivors; Metastatic melanoma; Nation-wide cohort; Productivity costs; Targeted therapy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antineoplastic Agents* / therapeutic use
Health Care Costs
Humans
Income
Melanoma* / drug therapy
Neoplasms, Second Primary*
Survivors

Substances

Antineoplastic Agents