Research Article

Economic burden of patients with advanced non-small-cell lung cancer receiving nivolumab versus chemotherapy in China

Qingqing Chai

Department of Pharmacy, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200000, China

School of Medicine, Shanghai Jiao Tong University, Shanghai 200000, China

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Yunjie Shen

Department of Pharmacy, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200000, China

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Jiangyang Du

School of Medicine, Shanghai Jiao Tong University, Shanghai 200000, China

Medical Decision & Economic Group, Department of Pharmacy, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200000, China

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Jun Zhu

Department of Pharmacy, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200000, China

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Bin Wu

*Author for correspondence:

E-mail Address: withtop@126.com

https://orcid.org/0000-0002-6696-7471

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Published Online:19 Mar 2020https://doi.org/10.2217/imt-2020-0030

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Abstract

Aim: As new treatment patterns are gradually being used in patients with non-small-cell lung cancer, it is necessary to have a better understanding of real-world data on clinical practices and their potential impact on healthcare resource utilization (HCRU). Patients & methods: A retrospective observational study was conducted with electronic medical records from Shanghai Chest Hospital. Hospitalized patients treated with nivolumab or second-line chemotherapy were included. Results: A total of 296 patients were included in this study, of whom 187 were treated with nivolumab. About 74.33% received nivolumab monotherapy at different doses. The mean cost of nivolumab was $3334.14 (±86.69). Nivolumab decreased inpatient days to 1.9545 days with a more stable cost and HCRU per cycle. Conclusion: Nivolumab is expensive but it reduces other HCRU.

Keywords:

Papers of special note have been highlighted as: • of interest; •• of considerable interest

References

1. SEER Incidence Data, 1975–2016. https://seer.cancer.gov/data/Google Scholar
2. Chen W, Zheng R, Baade PD et al. Cancer statistics in China, 2015. CA Cancer J. Clin. 66(2), 115–132 (2016).Crossref, Medline, Google Scholar
3. Proto C, Ferrara R, Signorelli D et al. Choosing wisely first line immunotherapy in non-small cell lung cancer (NSCLC): what to add and what to leave out. Cancer Treat. Rev. 75, 39–51 (2019).Crossref, Medline, CAS, Google Scholar
4. Arunachalam A, Li H, Bittoni MA et al. Real-world treatment patterns, overall survival, and occurrence and costs of adverse events associated with second-line therapies for Medicare patients with advanced non-small-cell lung cancer. Clin. Lung Cancer 19(5), e783–e799 (2018). •• This restrospective cohort study identifies 4033 patients with advanced non-small-cell lung cancer (NSCLC) who were treated with second-line therapy. In the real world, second-line therapy (not including the immunotherapies) illustrates the high cost.Crossref, Medline, Google Scholar
5. Wood R, Taylor-Stokes G. Cost burden associated with advanced non-small cell lung cancer in Europe and influence of disease stage. BMC Cancer 19(1), 214–214 (2019).Crossref, Medline, Google Scholar
6. Andreas S, Chouaid C, Danson S et al. Economic burden of resected (stage IB–IIIA) non-small cell lung cancer in France, Germany and the United Kingdom: a retrospective observational study (LuCaBIS). Lung Cancer 124, 298–309 (2018). • Describes the burden of illness of patients with resected stage IB–IIIA NSCLC in the UK, France and Germany. NSCLC takes large annual national costs, especially during its progression.Crossref, Medline, Google Scholar
7. Garrison LP Jr, Neumann PJ, Erickson P, Marshall D, Mullins CD. Using real-world data for coverage and payment decisions: the ISPOR Real-World Data Task Force report. Value Health 10(5), 326–335 (2007). • Real world data were important for decision making but also had limitations.Crossref, Medline, Google Scholar
8. Liu Q, Luo X, Peng L et al. Nivolumab versus docetaxel for previously treated advanced non-small cell lung cancer in China: a cost–effectiveness analysis. Clin. Drug Investig. 40(2), 129–137 (2020).Crossref, Medline, CAS, Google Scholar
9. Marine S, Stéphane R, Nicolas P et al. cost–effectiveness of atezolizumab versus docetaxel and nivolumab in the treatment of non-small cell lung cancer as a second line in France. J. Med. Econ. doi:10.1080/13696998.2020.1718156 1–10 (2020) (Epub ahead of print).Crossref, Medline, Google Scholar
10. Boone NW, Van Bodegraven AA. Less is more: a cost benefit analysis of a changed posology for nivolumab. Eur. J. Clin. Pharmacol. doi:10.1007/s00228-020-02839-7 (2020) (Epub ahead of print).Crossref, Medline, Google Scholar
11. Giuliani J, Bonetti A. Financial toxicity and non-small-cell lung cancer treatment: the optimization in the choice of immune check point inhibitors. Anticancer Res. 39(7), 3961–3965 (2019).Crossref, Medline, CAS, Google Scholar
12. Verma V, Sprave T, Haque W et al. A systematic review of the cost and cost–effectiveness studies of immune checkpoint inhibitors. J. Immunother. Cancer 6(1), 128–128 (2018).Crossref, Medline, Google Scholar
13. Borghaei H, Paz-Ares L, Horn L et al. Nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer. N. Engl. J. Med. 373(17), 1627–1639 (2015). •• Nivolumab shows its benefit for overall survival compared with docetaxel among patients with advanced nonsquamous NSCLC in a Phase III clinical trial, CheckMate 057.Crossref, Medline, CAS, Google Scholar
14. Horn L, Spigel DR, Vokes EE et al. Nivolumab versus docetaxel in previously treated patients with advanced non-small-cell lung cancer: two-year outcomes from two randomized, open-label, Phase III trials (CheckMate 017 and CheckMate 057). J. Clin. Oncol. 35(35), 3924–3933 (2017). • A report for the 2-year outcome for these two clinical trials: CheckMate 017 and CheckMate 057.Crossref, Medline, CAS, Google Scholar
15. Davies J, Patel M, Gridelli C, De Marinis F, Waterkamp D, Mccusker ME. Real-world treatment patterns for patients receiving second-line and third-line treatment for advanced non-small cell lung cancer: a systematic review of recently published studies. PLoS ONE 12(4), e0175679–e0175679 (2017).Crossref, Medline, Google Scholar
16. Wu Y-L, Lu S, Cheng Y et al. Nivolumab versus docetaxel in a predominantly chinese patient population with previously treated advanced NSCLC: CheckMate 078 randomized Phase iii clinical trial. J. Thorac. Oncol. 14(5), 867–875 (2019).Crossref, Medline, CAS, Google Scholar
17. Areses Manrique MC, Mosquera Martínez J, García González J et al. Real world data of nivolumab for previously treated non-small cell lung cancer patients: a Galician lung cancer group clinical experience. Transl. Lung Cancer Res. 7(3), 404–415 (2018). •• Another real-world data analysis for nivolumab in a Galician group, emphasizing the clinical outcome rather than disease burden.Crossref, Medline, Google Scholar
18. Da Veiga CRP, Da Veiga CP, Drummond-Lage AP. Concern over cost of and access to cancer treatments: a meta-narrative review of nivolumab and pembrolizumab studies. Crit. Rev. Oncol. Hematol. 129, 133–145 (2018).Crossref, Medline, Google Scholar
19. Kong J, Xu F, He M, Chen K, Qian B. The incidence of lung cancer by histological type: a population-based study in Tianjin, China during 1981–2005. Respirology 19(8), 1222–1228 (2014).Crossref, Medline, Google Scholar
20. Zhang X, Wu L, Xu Y et al. Trends in the incidence rate of lung cancer by histological type and gender in Sichuan, China, 1995–2015: a single-center retrospective study. Thoracic Cancer 9(5), 532–541 (2018).Crossref, Medline, CAS, Google Scholar

Vol. 12, No. 4

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History

Received 10 February 2020

Accepted 5 March 2020

Published online 19 March 2020

Published in print March 2020

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Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.futuremedicine.com/doi/suppl/10.2217/imt-2020-0030

Author contributions

All the authors participated in the completion of this manuscript and in the decision of submission. This analysis was designed and conducted by Dr Wu and Qingqing Chai. Yunjie Shen and Jiangyang Du had a role in data collection. Jun Zhu helped review and edit this manuscript.

Financial & competing interests disclosure

This work was sponsored by unrestricted grants from the National Natural Science Foundation of China (NO. 7172810 and 71373160) and Bristol-Myers Squibb AB, China. The study sponsors had no influence on the study design, data collection, or writing of the manuscript. Dr. Wu has received an unrestricted grant from Bristol-Myers Squibb AB, China. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that as this study is a retrospective study which based on the established database, ethical review could be exempted. All the study followed the Declaration of Helsinki.

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