University of Washington, School of Pharmacy, Seattle, WA
Anneliese M Bodding-Long , L. Elizabeth Budde , Jennifer E Roden , Ajay K. Gopal , Tara L Chen
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 | $26,200 | p=0.3 | $20,033 | p<0.05 |
Cost per Response (Non-Medication Related) | $3,780 | $19,109 | p<0.05 | $13,485 | p<0.05 |
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Abstract Disclosures
2015 ASCO Annual Meeting
First Author: L. Elizabeth Budde
2014 ASCO Annual Meeting
First Author: Sameh Gaballa
2023 ASCO Annual Meeting
First Author: Kristen McCullough
2023 ASCO Annual Meeting
First Author: Samer Ali Srour