DESCRIPTION OF PATIENT CHARACTERISTICS, TREATMENT PATTERNS AND RESOURCE USE FOR PATIENTS WITH MULTIPLE MYELOMA TREATED IN THREE LOCAL HEALTH UNITS (LHUS) IN ITALY
(Abstract release date: 05/19/16)
EHA Library. Panjabi S. 06/09/16; 132876; E1327
Ms. Sumeet Panjabi
Contributions
Contributions
Abstract
Abstract: E1327
Type: Eposter Presentation
Background
Recent data on resource utilization and treatment patterns in multiple myeloma (MM) in Italy are limited.
Aims
The objective of this study was to examine the resource utilization and treatment patterns of newly-diagnosed patients with MM in Italy.
Methods
Retrospective claims data from the administrative databases of three LHUs in Lazio, Sicily, and Lombardy in Italy were used. Patients with a hospitalization discharge diagnosis of MM between 1 January 2008 and 1 September 2013 were included. To identify newly-diagnosed cases, patients with a prior MM diagnosis or a prior prescription for bortezomib (Bor), thalidomide (Thal), melphalan (Mel), lenalidomide (Len) or cyclophosphamide (Cyc) 12 months prior to entry into the study cohort were excluded. Index date was defined as the earliest of: date of first MM diagnosis or first prescription of Bor, Thal, Mel, Len, Cyc, prednisone or dexamethasone in patients with a diagnosis of MM within six months following prescription date; or the visit date to an oncologist or hematologist in patients with a diagnosis of MM within six months following the visit date. The baseline period was defined as 12 months prior to index date and the follow-up period ranged from the index date (inclusive) until date of last data collection or patient’s death. Data on patients’ demographics and clinical characteristics were collected at baseline. Healthcare resource use and treatment patterns were explored during the entire study period. The identification of treatment lines was based on assumptions given the sequencing of treatments based on key literature and treatment guidelines in Italy.
Results
Overall, 938 patients with MM entered the study cohort; average follow-up was 1.7 years. A total of 157 patients underwent a stem-cell transplantation (SCT) during the study period. The mean age at diagnosis was 69.7 years (standard deviation [SD]: 12.3). A slight majority of patients were female (52%). The most common comorbidities at baseline were renal disease (5.9 %), other malignancies (5.8%) and congestive heart failure (4.4%). Among 814 patients with at least three months of follow-up, 76.4 % of patients received at least one treatment line and 40.8% and 18.3% received at least two and three lines, respectively. Mel (27.7%) and Bor (21.5%) were the most frequently administered first- and second-line treatments, while Len showed an increased uptake in third line and beyond. Bor was the most commonly used first-line treatment in SCT patients (31.3%), while Mel was the most commonly used first-line treatment for non-SCT patients (36.5%). During the entire follow-up period, 80% of patients had at least one hospitalization for MM, 74% of patients had at least one laboratory test and 63% at least one diagnostic test, with the most common procedure being biopsy of bone marrow (53%). The mean annual cost of hospitalizations and medications per patient was €13,558 (SD: 17,559) and €2,401 (5,532), respectively. The average annual cost of medication per patient increased from €2,590 (5,566) for patients in first-line to €3,253 (8,767) and €4,330 (11,439) for patients in second- and third-line, respectively.
Conclusion
MM poses a significant economic burden on the national health system in Italy with hospitalizations being the main cost driver. Treatment patterns data indicate an unmet need for more effective therapies in Italy.
Session topic: E-poster
Keyword(s): Multiple myeloma
Type: Eposter Presentation
Background
Recent data on resource utilization and treatment patterns in multiple myeloma (MM) in Italy are limited.
Aims
The objective of this study was to examine the resource utilization and treatment patterns of newly-diagnosed patients with MM in Italy.
Methods
Retrospective claims data from the administrative databases of three LHUs in Lazio, Sicily, and Lombardy in Italy were used. Patients with a hospitalization discharge diagnosis of MM between 1 January 2008 and 1 September 2013 were included. To identify newly-diagnosed cases, patients with a prior MM diagnosis or a prior prescription for bortezomib (Bor), thalidomide (Thal), melphalan (Mel), lenalidomide (Len) or cyclophosphamide (Cyc) 12 months prior to entry into the study cohort were excluded. Index date was defined as the earliest of: date of first MM diagnosis or first prescription of Bor, Thal, Mel, Len, Cyc, prednisone or dexamethasone in patients with a diagnosis of MM within six months following prescription date; or the visit date to an oncologist or hematologist in patients with a diagnosis of MM within six months following the visit date. The baseline period was defined as 12 months prior to index date and the follow-up period ranged from the index date (inclusive) until date of last data collection or patient’s death. Data on patients’ demographics and clinical characteristics were collected at baseline. Healthcare resource use and treatment patterns were explored during the entire study period. The identification of treatment lines was based on assumptions given the sequencing of treatments based on key literature and treatment guidelines in Italy.
Results
Overall, 938 patients with MM entered the study cohort; average follow-up was 1.7 years. A total of 157 patients underwent a stem-cell transplantation (SCT) during the study period. The mean age at diagnosis was 69.7 years (standard deviation [SD]: 12.3). A slight majority of patients were female (52%). The most common comorbidities at baseline were renal disease (5.9 %), other malignancies (5.8%) and congestive heart failure (4.4%). Among 814 patients with at least three months of follow-up, 76.4 % of patients received at least one treatment line and 40.8% and 18.3% received at least two and three lines, respectively. Mel (27.7%) and Bor (21.5%) were the most frequently administered first- and second-line treatments, while Len showed an increased uptake in third line and beyond. Bor was the most commonly used first-line treatment in SCT patients (31.3%), while Mel was the most commonly used first-line treatment for non-SCT patients (36.5%). During the entire follow-up period, 80% of patients had at least one hospitalization for MM, 74% of patients had at least one laboratory test and 63% at least one diagnostic test, with the most common procedure being biopsy of bone marrow (53%). The mean annual cost of hospitalizations and medications per patient was €13,558 (SD: 17,559) and €2,401 (5,532), respectively. The average annual cost of medication per patient increased from €2,590 (5,566) for patients in first-line to €3,253 (8,767) and €4,330 (11,439) for patients in second- and third-line, respectively.
Conclusion
MM poses a significant economic burden on the national health system in Italy with hospitalizations being the main cost driver. Treatment patterns data indicate an unmet need for more effective therapies in Italy.
Session topic: E-poster
Keyword(s): Multiple myeloma
Abstract: E1327
Type: Eposter Presentation
Background
Recent data on resource utilization and treatment patterns in multiple myeloma (MM) in Italy are limited.
Aims
The objective of this study was to examine the resource utilization and treatment patterns of newly-diagnosed patients with MM in Italy.
Methods
Retrospective claims data from the administrative databases of three LHUs in Lazio, Sicily, and Lombardy in Italy were used. Patients with a hospitalization discharge diagnosis of MM between 1 January 2008 and 1 September 2013 were included. To identify newly-diagnosed cases, patients with a prior MM diagnosis or a prior prescription for bortezomib (Bor), thalidomide (Thal), melphalan (Mel), lenalidomide (Len) or cyclophosphamide (Cyc) 12 months prior to entry into the study cohort were excluded. Index date was defined as the earliest of: date of first MM diagnosis or first prescription of Bor, Thal, Mel, Len, Cyc, prednisone or dexamethasone in patients with a diagnosis of MM within six months following prescription date; or the visit date to an oncologist or hematologist in patients with a diagnosis of MM within six months following the visit date. The baseline period was defined as 12 months prior to index date and the follow-up period ranged from the index date (inclusive) until date of last data collection or patient’s death. Data on patients’ demographics and clinical characteristics were collected at baseline. Healthcare resource use and treatment patterns were explored during the entire study period. The identification of treatment lines was based on assumptions given the sequencing of treatments based on key literature and treatment guidelines in Italy.
Results
Overall, 938 patients with MM entered the study cohort; average follow-up was 1.7 years. A total of 157 patients underwent a stem-cell transplantation (SCT) during the study period. The mean age at diagnosis was 69.7 years (standard deviation [SD]: 12.3). A slight majority of patients were female (52%). The most common comorbidities at baseline were renal disease (5.9 %), other malignancies (5.8%) and congestive heart failure (4.4%). Among 814 patients with at least three months of follow-up, 76.4 % of patients received at least one treatment line and 40.8% and 18.3% received at least two and three lines, respectively. Mel (27.7%) and Bor (21.5%) were the most frequently administered first- and second-line treatments, while Len showed an increased uptake in third line and beyond. Bor was the most commonly used first-line treatment in SCT patients (31.3%), while Mel was the most commonly used first-line treatment for non-SCT patients (36.5%). During the entire follow-up period, 80% of patients had at least one hospitalization for MM, 74% of patients had at least one laboratory test and 63% at least one diagnostic test, with the most common procedure being biopsy of bone marrow (53%). The mean annual cost of hospitalizations and medications per patient was €13,558 (SD: 17,559) and €2,401 (5,532), respectively. The average annual cost of medication per patient increased from €2,590 (5,566) for patients in first-line to €3,253 (8,767) and €4,330 (11,439) for patients in second- and third-line, respectively.
Conclusion
MM poses a significant economic burden on the national health system in Italy with hospitalizations being the main cost driver. Treatment patterns data indicate an unmet need for more effective therapies in Italy.
Session topic: E-poster
Keyword(s): Multiple myeloma
Type: Eposter Presentation
Background
Recent data on resource utilization and treatment patterns in multiple myeloma (MM) in Italy are limited.
Aims
The objective of this study was to examine the resource utilization and treatment patterns of newly-diagnosed patients with MM in Italy.
Methods
Retrospective claims data from the administrative databases of three LHUs in Lazio, Sicily, and Lombardy in Italy were used. Patients with a hospitalization discharge diagnosis of MM between 1 January 2008 and 1 September 2013 were included. To identify newly-diagnosed cases, patients with a prior MM diagnosis or a prior prescription for bortezomib (Bor), thalidomide (Thal), melphalan (Mel), lenalidomide (Len) or cyclophosphamide (Cyc) 12 months prior to entry into the study cohort were excluded. Index date was defined as the earliest of: date of first MM diagnosis or first prescription of Bor, Thal, Mel, Len, Cyc, prednisone or dexamethasone in patients with a diagnosis of MM within six months following prescription date; or the visit date to an oncologist or hematologist in patients with a diagnosis of MM within six months following the visit date. The baseline period was defined as 12 months prior to index date and the follow-up period ranged from the index date (inclusive) until date of last data collection or patient’s death. Data on patients’ demographics and clinical characteristics were collected at baseline. Healthcare resource use and treatment patterns were explored during the entire study period. The identification of treatment lines was based on assumptions given the sequencing of treatments based on key literature and treatment guidelines in Italy.
Results
Overall, 938 patients with MM entered the study cohort; average follow-up was 1.7 years. A total of 157 patients underwent a stem-cell transplantation (SCT) during the study period. The mean age at diagnosis was 69.7 years (standard deviation [SD]: 12.3). A slight majority of patients were female (52%). The most common comorbidities at baseline were renal disease (5.9 %), other malignancies (5.8%) and congestive heart failure (4.4%). Among 814 patients with at least three months of follow-up, 76.4 % of patients received at least one treatment line and 40.8% and 18.3% received at least two and three lines, respectively. Mel (27.7%) and Bor (21.5%) were the most frequently administered first- and second-line treatments, while Len showed an increased uptake in third line and beyond. Bor was the most commonly used first-line treatment in SCT patients (31.3%), while Mel was the most commonly used first-line treatment for non-SCT patients (36.5%). During the entire follow-up period, 80% of patients had at least one hospitalization for MM, 74% of patients had at least one laboratory test and 63% at least one diagnostic test, with the most common procedure being biopsy of bone marrow (53%). The mean annual cost of hospitalizations and medications per patient was €13,558 (SD: 17,559) and €2,401 (5,532), respectively. The average annual cost of medication per patient increased from €2,590 (5,566) for patients in first-line to €3,253 (8,767) and €4,330 (11,439) for patients in second- and third-line, respectively.
Conclusion
MM poses a significant economic burden on the national health system in Italy with hospitalizations being the main cost driver. Treatment patterns data indicate an unmet need for more effective therapies in Italy.
Session topic: E-poster
Keyword(s): Multiple myeloma
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