BACKGROUND AND OBJECTIVE: The objective of this study was to estimate the lifetime costs of patients receiving treatment for follicular lymphoma (FL) in the United States. METHODS: A Markov model was programmed in hēRo3 with a 6-month cycle length, 35-year time horizon (lifetime projection), and health states for line of treatment, response, receipt of maintenance therapy among responders, transformation to diffuse large B-cell lymphoma (DLBCL), development of second primary malignancy (SPM), and death. The model was used to estimate the expected lifetime costs of FL (in 2019 USD), including costs of drug acquisition and administration, transplant procedures, radiotherapy, adverse events, follow-up, DLBCL, SPM, end-of-life care, and indirect costs. Model inputs were based on published sources. RESULTS: In the US, patients with FL receiving treatment have a life expectancy of approximately 14.5 years from initiation of treatment and expected lifetime direct and indirect costs of US$515,884. Costs of drugs for induction therapy represent the largest expenditure (US$233,174), followed by maintenance therapy costs (US$88,971) and terminal care costs (US$57,065). Despite the relatively advanced age of these patients, indirect costs (due to patient morbidity and mortality and caregiver lost work time) represent a substantial share of total costs (US$40,280). Treated FL patients spend approximately 6.9 years in the health states associated with first-line therapy. Approximately 66 and 46% continue to second- and third-line therapies, respectively. The mean (95% credible interval) of expected lifetime costs based on the probabilistic sensitivity analyses was US$559,202 (421,997-762,553). CONCLUSIONS: In the US, the expected lifetime costs of care for FL patients who receive treatment is high. The results highlight the potential economic benefits that might be achieved by treatments for FL that prevent or delay disease progression.
BACKGROUND AND OBJECTIVE: The objective of this study was to estimate the lifetime costs of patients receiving treatment for follicular lymphoma (FL) in the United States. METHODS: A Markov model was programmed in hēRo3 with a 6-month cycle length, 35-year time horizon (lifetime projection), and health states for line of treatment, response, receipt of maintenance therapy among responders, transformation to diffuse large B-cell lymphoma (DLBCL), development of second primary malignancy (SPM), and death. The model was used to estimate the expected lifetime costs of FL (in 2019 USD), including costs of drug acquisition and administration, transplant procedures, radiotherapy, adverse events, follow-up, DLBCL, SPM, end-of-life care, and indirect costs. Model inputs were based on published sources. RESULTS: In the US, patients with FL receiving treatment have a life expectancy of approximately 14.5 years from initiation of treatment and expected lifetime direct and indirect costs of US$515,884. Costs of drugs for induction therapy represent the largest expenditure (US$233,174), followed by maintenance therapy costs (US$88,971) and terminal care costs (US$57,065). Despite the relatively advanced age of these patients, indirect costs (due to patient morbidity and mortality and caregiver lost work time) represent a substantial share of total costs (US$40,280). Treated FL patients spend approximately 6.9 years in the health states associated with first-line therapy. Approximately 66 and 46% continue to second- and third-line therapies, respectively. The mean (95% credible interval) of expected lifetime costs based on the probabilistic sensitivity analyses was US$559,202 (421,997-762,553). CONCLUSIONS: In the US, the expected lifetime costs of care for FL patients who receive treatment is high. The results highlight the potential economic benefits that might be achieved by treatments for FL that prevent or delay disease progression.
Authors: Ian W Flinn; Carole B Miller; Kirit M Ardeshna; Scott Tetreault; Sarit E Assouline; Jiri Mayer; Michele Merli; Scott D Lunin; Andrew R Pettitt; Zoltan Nagy; Olivier Tournilhac; Karem-Etienne Abou-Nassar; Michael Crump; Eric D Jacobsen; Sven de Vos; Virginia M Kelly; Weiliang Shi; Lori Steelman; NgocDiep Le; David T Weaver; Stephanie Lustgarten; Nina D Wagner-Johnston; Pier Luigi Zinzani Journal: J Clin Oncol Date: 2019-02-11 Impact factor: 44.544
Authors: Marinus H J van Oers; Martine Van Glabbeke; Livia Giurgea; Richard Klasa; Robert E Marcus; Max Wolf; Eva Kimby; Mars van t Veer; Andrej Vranovsky; Harald Holte; Anton Hagenbeek Journal: J Clin Oncol Date: 2010-05-03 Impact factor: 44.544
Authors: Ajay K Gopal; Brad S Kahl; Sven de Vos; Nina D Wagner-Johnston; Stephen J Schuster; Wojciech J Jurczak; Ian W Flinn; Christopher R Flowers; Peter Martin; Andreas Viardot; Kristie A Blum; Andre H Goy; Andrew J Davies; Pier Luigi Zinzani; Martin Dreyling; Dave Johnson; Langdon L Miller; Leanne Holes; Daniel Li; Roger D Dansey; Wayne R Godfrey; Gilles A Salles Journal: N Engl J Med Date: 2014-01-22 Impact factor: 91.245
Authors: Angela B Mariotto; K Robin Yabroff; Yongwu Shao; Eric J Feuer; Martin L Brown Journal: J Natl Cancer Inst Date: 2011-01-12 Impact factor: 13.506
Authors: Emmanuel Bachy; John F Seymour; Pierre Feugier; Fritz Offner; Armando López-Guillermo; David Belada; Luc Xerri; John V Catalano; Pauline Brice; François Lemonnier; Alejandro Martin; Olivier Casasnovas; Lars M Pedersen; Véronique Dorvaux; David Simpson; Sirpa Leppa; Jean Gabarre; Maria G da Silva; Sylvie Glaisner; Loic Ysebaert; Anne Vekhoff; Tanin Intragumtornchai; Steven Le Gouill; Andrew Lister; Jane A Estell; Gustavo Milone; Anne Sonet; Jonathan Farhi; Harald Zeuner; Hervé Tilly; Gilles Salles Journal: J Clin Oncol Date: 2019-07-24 Impact factor: 44.544
Authors: M Dreyling; F Morschhauser; K Bouabdallah; D Bron; D Cunningham; S E Assouline; G Verhoef; K Linton; C Thieblemont; U Vitolo; F Hiemeyer; M Giurescu; J Garcia-Vargas; I Gorbatchevsky; L Liu; K Koechert; C Peña; M Neves; B H Childs; P L Zinzani Journal: Ann Oncol Date: 2017-09-01 Impact factor: 32.976