Cost-comparison analysis of bendamustine, rituximab, etoposide and carboplatin (TREC) vs. RICE/R-DHAP in relapsed lymphoma.

Authors

null

Anneliese M Bodding-Long

University of Washington, School of Pharmacy, Seattle, WA

Anneliese M Bodding-Long , L. Elizabeth Budde , Jennifer E Roden , Ajay K. Gopal , Tara L Chen

Organizations

University of Washington, School of Pharmacy, Seattle, WA, City of Hope National Medical Center, Duarte, CA, Seattle Cancer Care Alliance, Seattle, WA, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA

Research Funding

No funding sources reported

Background: A multicenter phase I study (Budde et al. ASH 2012, final results ASCO 2015) confirmed the safety and efficacy of supplanting ifosfamide with bendamustine within the regimen RICE for relapsed/refractory lymphoma (TREC). TREC is administered in the outpatient setting compared with other salvage strategies which require hospitalization. We hypothesized that TREC would confer cost savings and yield a lower cost per response vs. RICE/R-DHAP. Methods: Medication and non-medication costs (facility, labor, laboratory, etc.) were collected on patients treated with at least one cycle of TREC or RICE/R-DHAP between 7/2010-7/2012. A cost-consequence analysis comparing regimen costs to efficacy results was conducted using a standardized RR of 70%, based on results from the phase I trial and those reported in the literature for RICE/R-DHAP. Results: Baseline demographics were similar between TREC and RICE/R-DHAP groups. The average cost of one cycle of TREC was similar to RICE and R-DHAP. Medication costs were higher with TREC, representing the majority of total regimen cost. Non-medication costs were higher with RICE/R-DHAP, reflecting higher costs associated with facility, labor, and inpatient admissions. The total cost per response was similar between groups; removing drug-related costs, the cost per response of TREC is significantly lower. Conclusions: Although total costs were similar for outpatient TREC compared to inpatient salvage regimens, most of the costs were attributable to the high-cost of bendamustine. Lower medication-related costs and outpatient administration could yield considerable cost savings and lower cost-per-response.

TREC
(n=7)
RICE
(n=23)
TREC vs.
RICE
R-DHAP
(n=7)
TREC vs.
R-DHAP
Total Cost
Average
(Range)
$19,031
($15,960- $24,973)
$18,340
($12,774-25,779)
p=0.6$14,023
($12,091-$15,920)
p<0.05
Medication Costs
(% of Total Cost)
Average$16,385
(86%)
$4,964
(27%)
$4,584
(33%)
Non-Medication Costs
(% of Total Cost)
Average$2,646
(14%)
$13,376
(73%)
$9,439
(67%)
Cost per Response
Total Cost per Response$27,187$26,200p=0.3$20,033p<0.05
Cost per Response
(Non-Medication Related)
$3,780$19,109p<0.05$13,485p<0.05

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Abstract Details

Meeting

2015 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Lymphoma and Plasma Cell Disorders

Track

Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Sub Track

Lymphoma

Citation

J Clin Oncol 33, 2015 (suppl; abstr e19517)

DOI

10.1200/jco.2015.33.15_suppl.e19517

Abstract #

e19517

Abstract Disclosures