1101P - Healthcare resource utilization (HCRU) in patients receiving ipilimumab for advanced melanoma: Impact of survival and Eastern Cooperative Oncology...

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Bioethics, Legal, and Economic Issues
Cancer Immunology and Immunotherapy
Melanoma and other Skin Tumours
Presenter Ahmad Tarhini
Citation Annals of Oncology (2014) 25 (suppl_4): iv374-iv393. 10.1093/annonc/mdu344
Authors A. Tarhini1, A.S. Rao2, S. Corman3, M. Botteman3, S. Mehta3, X. Ji3, M. Katyal4, K. Margolin5
  • 1Division Of Hematology/oncology, University of Pittsburgh Schools of the Health Sciences, 15232 - Pittsburgh/US
  • 2Heor, Oncology, Bristol-Myers Squibb, Plainsboro/US
  • 3Outcomes Research, Pharmerit International, Bethesda/US
  • 4Heor, Medical Data Analytics, Parsippany/US
  • 5Medical Oncology, Seattle Cancer Care Alliance, Seattle/US

Abstract

Aim

A recent large pooled survival analysis has shown that ipilimumab (ipi) conveys long-term survival benefit in a significant proportion of patients (pts) with advanced melanoma (mel). We conducted a retrospective study of clinical outcomes and adverse events (AEs) among pts receiving ipi in a real world setting which may define whether longer survival is associated with increased HCRU. The present analysis describes HCRU by length of survival and baseline ECOG status.

Methods

This medical chart review comprised adult pts in the US with unresectable stage III/IV mel treated in a community setting with ≥1 dose of ipi 3 mg/kg as first-line monotherapy between 04/2011 and 09/2012. Demographic/clinical characteristics, details of ipi dosing and subsequent therapies, AEs, and HCRU (hospitalizations, emergency department (ED) visits, nursing home stays) were collected. Pts were categorized according to survival (<1 year vs. ≥1 year) and baseline ECOG status (0 vs. ≥1). HCRU per pt was compared using ANOVA and chi-square tests.

Results

Data were abstracted from 273 pt charts at 34 sites. As of 12/20/2013, 231 pts had been followed ≥1 year or until death, and 200 had ECOG status recorded. The 4 groups were similar in age (median 64 years), sex (66% male), and race (95% white). More hospitalizations per pt occurred among pts surviving <1 year vs. ≥1 year, and pts with ECOG status ≥1 vs. 0 (p < 0.001 for both). Pts who survived <1 year had more hospitalizations and hospital days if their baseline ECOG status was ≥1 compared to 0, while ECOG status did not appear to impact HCRU among pts who survived ≥1 year.

Conclusions

In this population, the rate of resource use was lower among those surviving ≥1 year than among those surviving <1 year. Baseline ECOG status ≥1 was associated with greater HCRU only among pts surviving <1 year. Prolonged survival appears to be associated with reduced HCRU among this patient population.

Healthcare Resource Utilization during Follow-Up, Mean (SD)

Survived ≥1 yearECOG 0N = 55 Survived ≥1 yearECOG ≥1N = 51 Survived <1 yearECOG 0N = 26 Survived <1 yearECOG ≥1N = 68
HospitalizationsNumber per pt per 100 days*Total days per pt per 100 days* 0.08 (0.16)0.49 (1.17) 0.09 (0.19)0.35 (0.79) 0.50 (0.70)2.22 (3.45) 1.13 (1.77)5.12 (8.93)
Emergency department visits, number per pt per 100 days 0.01 (0.05) 0.02 (0.11) 0 (0) 0.02 (0.07)
Nursing home staysPts (%)Total days per pt per 100 days 1.8%0.04 (0.30) 5.9%0.46 (2.01) 7.7%1.63 (7.20) 7.4%1.89 (9.00)

* p < 0.001.

Disclosure

A. Tarhini: Advisory boards: Bristol-Myers Squibb, Merck, and Genentech; Corporate-sponsored research: Bristol-Myers Squibb, Merck, Novartis, Amgen, and Prometheus. A.S. Rao: Employee of Bristol-Myers Squibb. S. Corman: Employee of Pharmerit International; consulting fee or honorarium paid by Bristol-Myers Squibb to Pharmerit International. M. Botteman: employee of Pharmerit International; consulting fee from Bristol-Myers Squibb during the conduct of the study. S. Mehta: employee of Pharmerit International; consulting fee or honorarium paid by Bristol-Myers Squibb to Pharmerit International. X. Ji: employee of Pharmerit International; consulting fee or honorarium paid by Bristol-Myers Squibb to Pharmerit International. M. Katyal: Employee of Medical Data Analytics; corporate-sponsored research: Medical Data Analytics is consultant vendor to Bristol-Myers Squibb, Inc., the financial sponsor of this research study. K. Margolin: Corporate-sponsored research: GlaxoSmithKline, Bristol-Myers Squibb, Genentech, Pfizer, Altor, and Prometheus.