Healthcare resource utilization and associated cost analysis of the PROCLAIM study in patients with stage III non-small-cell lung cancer

Ramaswamy Govindan, Suresh Senan, Nicolas Dickgreber, Mariano Provencio, Yi-Long Wu, Konstantinos Syrigos, Barbara Parente, Michele Wilson, Ryan Ziemiecki, Nadia Chouaki, Anwar Hossain, Belén San Antonio, Katherine Winfree, Everett E. Vokes

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective: To analyze patient-reported swallowing difficulties, healthcare resource utilization and associated costs during the PROCLAIM study. Methods: Patients with stage III non-squamous non-small cell lung cancer received pemetrexed-cisplatin (PemCis) combined with concurrent thoracic radiotherapy followed by consolidation pemetrexed, or concurrent chemoradiotherapy with etoposide-cisplatin (EtoCis) followed by standard consolidation chemotherapy. Patient - reported swallowing function was measured using diaries. Resource utilization (hospitalizations, transfusions, concomitant medications) was compared between treatment arms using Fisher’s exact test and independent t-test. Medical resource use costs were analyzed using nonparametric Wilcoxon rank sum test. Results: Patient-reported difficulty in swallowing function (diary score ≥4) was 33.8% in the PemCis arm and 29% in the EtoCis arm. Overall resource use, including hospitalizations, was similar between treatment arms; however, fewer patients in the PemCis arm received transfusions and selected concomitant medications. Concurrent phase analyses were consistent with the overall study. A significantly lower percentage of patients (31.1% vs. 40.8%) were hospitalized in the PemCis arm. Total costs were significantly higher in the PemCis arm. Other medical costs (excluding study treatment costs) during the concurrent phase were lower for patients in the PemCis arm, due to significantly lower hospitalization costs and lower use of concomitant medications. Subgroup analysis yielded similar results. Conclusions: Patient-reported difficulty in swallowing post-baseline and resource utilization were consistent with previously reported safety outcomes. In the overall study, higher total costs for PemCis were driven by study drug cost. When adjusting for treatment duration, other monthly medical costs were favorable to PemCis. Patients on pemetrexed remained longer on therapy, suggesting better tolerability. ClinicalTrials.gov identifier: NCT00686959.
Original languageEnglish
Pages (from-to)1761-1767
Number of pages7
JournalCurrent Medical Research and Opinion
Volume35
Issue number10
Early online date24 May 2019
DOIs
Publication statusPublished - 3 Oct 2019

Cite this

Govindan, Ramaswamy ; Senan, Suresh ; Dickgreber, Nicolas ; Provencio, Mariano ; Wu, Yi-Long ; Syrigos, Konstantinos ; Parente, Barbara ; Wilson, Michele ; Ziemiecki, Ryan ; Chouaki, Nadia ; Hossain, Anwar ; San Antonio, Belén ; Winfree, Katherine ; Vokes, Everett E. / Healthcare resource utilization and associated cost analysis of the PROCLAIM study in patients with stage III non-small-cell lung cancer. In: Current Medical Research and Opinion. 2019 ; Vol. 35, No. 10. pp. 1761-1767.
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title = "Healthcare resource utilization and associated cost analysis of the PROCLAIM study in patients with stage III non-small-cell lung cancer",
abstract = "Objective: To analyze patient-reported swallowing difficulties, healthcare resource utilization and associated costs during the PROCLAIM study. Methods: Patients with stage III non-squamous non-small cell lung cancer received pemetrexed-cisplatin (PemCis) combined with concurrent thoracic radiotherapy followed by consolidation pemetrexed, or concurrent chemoradiotherapy with etoposide-cisplatin (EtoCis) followed by standard consolidation chemotherapy. Patient - reported swallowing function was measured using diaries. Resource utilization (hospitalizations, transfusions, concomitant medications) was compared between treatment arms using Fisher’s exact test and independent t-test. Medical resource use costs were analyzed using nonparametric Wilcoxon rank sum test. Results: Patient-reported difficulty in swallowing function (diary score ≥4) was 33.8{\%} in the PemCis arm and 29{\%} in the EtoCis arm. Overall resource use, including hospitalizations, was similar between treatment arms; however, fewer patients in the PemCis arm received transfusions and selected concomitant medications. Concurrent phase analyses were consistent with the overall study. A significantly lower percentage of patients (31.1{\%} vs. 40.8{\%}) were hospitalized in the PemCis arm. Total costs were significantly higher in the PemCis arm. Other medical costs (excluding study treatment costs) during the concurrent phase were lower for patients in the PemCis arm, due to significantly lower hospitalization costs and lower use of concomitant medications. Subgroup analysis yielded similar results. Conclusions: Patient-reported difficulty in swallowing post-baseline and resource utilization were consistent with previously reported safety outcomes. In the overall study, higher total costs for PemCis were driven by study drug cost. When adjusting for treatment duration, other monthly medical costs were favorable to PemCis. Patients on pemetrexed remained longer on therapy, suggesting better tolerability. ClinicalTrials.gov identifier: NCT00686959.",
keywords = "PROCLAIM, Stage III NSCLC, cost analysis, pemetrexed, resource utilization",
author = "Ramaswamy Govindan and Suresh Senan and Nicolas Dickgreber and Mariano Provencio and Yi-Long Wu and Konstantinos Syrigos and Barbara Parente and Michele Wilson and Ryan Ziemiecki and Nadia Chouaki and Anwar Hossain and {San Antonio}, Bel{\'e}n and Katherine Winfree and Vokes, {Everett E.}",
year = "2019",
month = "10",
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doi = "10.1080/03007995.2019.1623185",
language = "English",
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Govindan, R, Senan, S, Dickgreber, N, Provencio, M, Wu, Y-L, Syrigos, K, Parente, B, Wilson, M, Ziemiecki, R, Chouaki, N, Hossain, A, San Antonio, B, Winfree, K & Vokes, EE 2019, 'Healthcare resource utilization and associated cost analysis of the PROCLAIM study in patients with stage III non-small-cell lung cancer' Current Medical Research and Opinion, vol. 35, no. 10, pp. 1761-1767. https://doi.org/10.1080/03007995.2019.1623185

Healthcare resource utilization and associated cost analysis of the PROCLAIM study in patients with stage III non-small-cell lung cancer. / Govindan, Ramaswamy; Senan, Suresh; Dickgreber, Nicolas; Provencio, Mariano; Wu, Yi-Long; Syrigos, Konstantinos; Parente, Barbara; Wilson, Michele; Ziemiecki, Ryan; Chouaki, Nadia; Hossain, Anwar; San Antonio, Belén; Winfree, Katherine; Vokes, Everett E.

In: Current Medical Research and Opinion, Vol. 35, No. 10, 03.10.2019, p. 1761-1767.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Healthcare resource utilization and associated cost analysis of the PROCLAIM study in patients with stage III non-small-cell lung cancer

AU - Govindan, Ramaswamy

AU - Senan, Suresh

AU - Dickgreber, Nicolas

AU - Provencio, Mariano

AU - Wu, Yi-Long

AU - Syrigos, Konstantinos

AU - Parente, Barbara

AU - Wilson, Michele

AU - Ziemiecki, Ryan

AU - Chouaki, Nadia

AU - Hossain, Anwar

AU - San Antonio, Belén

AU - Winfree, Katherine

AU - Vokes, Everett E.

PY - 2019/10/3

Y1 - 2019/10/3

N2 - Objective: To analyze patient-reported swallowing difficulties, healthcare resource utilization and associated costs during the PROCLAIM study. Methods: Patients with stage III non-squamous non-small cell lung cancer received pemetrexed-cisplatin (PemCis) combined with concurrent thoracic radiotherapy followed by consolidation pemetrexed, or concurrent chemoradiotherapy with etoposide-cisplatin (EtoCis) followed by standard consolidation chemotherapy. Patient - reported swallowing function was measured using diaries. Resource utilization (hospitalizations, transfusions, concomitant medications) was compared between treatment arms using Fisher’s exact test and independent t-test. Medical resource use costs were analyzed using nonparametric Wilcoxon rank sum test. Results: Patient-reported difficulty in swallowing function (diary score ≥4) was 33.8% in the PemCis arm and 29% in the EtoCis arm. Overall resource use, including hospitalizations, was similar between treatment arms; however, fewer patients in the PemCis arm received transfusions and selected concomitant medications. Concurrent phase analyses were consistent with the overall study. A significantly lower percentage of patients (31.1% vs. 40.8%) were hospitalized in the PemCis arm. Total costs were significantly higher in the PemCis arm. Other medical costs (excluding study treatment costs) during the concurrent phase were lower for patients in the PemCis arm, due to significantly lower hospitalization costs and lower use of concomitant medications. Subgroup analysis yielded similar results. Conclusions: Patient-reported difficulty in swallowing post-baseline and resource utilization were consistent with previously reported safety outcomes. In the overall study, higher total costs for PemCis were driven by study drug cost. When adjusting for treatment duration, other monthly medical costs were favorable to PemCis. Patients on pemetrexed remained longer on therapy, suggesting better tolerability. ClinicalTrials.gov identifier: NCT00686959.

AB - Objective: To analyze patient-reported swallowing difficulties, healthcare resource utilization and associated costs during the PROCLAIM study. Methods: Patients with stage III non-squamous non-small cell lung cancer received pemetrexed-cisplatin (PemCis) combined with concurrent thoracic radiotherapy followed by consolidation pemetrexed, or concurrent chemoradiotherapy with etoposide-cisplatin (EtoCis) followed by standard consolidation chemotherapy. Patient - reported swallowing function was measured using diaries. Resource utilization (hospitalizations, transfusions, concomitant medications) was compared between treatment arms using Fisher’s exact test and independent t-test. Medical resource use costs were analyzed using nonparametric Wilcoxon rank sum test. Results: Patient-reported difficulty in swallowing function (diary score ≥4) was 33.8% in the PemCis arm and 29% in the EtoCis arm. Overall resource use, including hospitalizations, was similar between treatment arms; however, fewer patients in the PemCis arm received transfusions and selected concomitant medications. Concurrent phase analyses were consistent with the overall study. A significantly lower percentage of patients (31.1% vs. 40.8%) were hospitalized in the PemCis arm. Total costs were significantly higher in the PemCis arm. Other medical costs (excluding study treatment costs) during the concurrent phase were lower for patients in the PemCis arm, due to significantly lower hospitalization costs and lower use of concomitant medications. Subgroup analysis yielded similar results. Conclusions: Patient-reported difficulty in swallowing post-baseline and resource utilization were consistent with previously reported safety outcomes. In the overall study, higher total costs for PemCis were driven by study drug cost. When adjusting for treatment duration, other monthly medical costs were favorable to PemCis. Patients on pemetrexed remained longer on therapy, suggesting better tolerability. ClinicalTrials.gov identifier: NCT00686959.

KW - PROCLAIM

KW - Stage III NSCLC

KW - cost analysis

KW - pemetrexed

KW - resource utilization

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UR - https://www.ncbi.nlm.nih.gov/pubmed/31125266

U2 - 10.1080/03007995.2019.1623185

DO - 10.1080/03007995.2019.1623185

M3 - Article

VL - 35

SP - 1761

EP - 1767

JO - Current Medical Research and Opinion

JF - Current Medical Research and Opinion

SN - 0300-7995

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ER -