title: Immunotherapy in the initial treatment of newly diagnosed cancer patients: utilization trend and cost projections for non-Hodgkin's lymphoma, metastatic breast cancer, and metastatic colorectal cancer.
abstract: We analyzed the utilization trend for immunotherapy as initial treatment in the United States and estimated the cost impact of three cancers for which the majority of newly approved immunotherapies were indicated: non-Hodgkin's lymphoma (NHL), metastatic breast cancer (MBC), and metastatic colorectal cancer (MCRC). Utilization was highly concentrated, with four cancers accounting for 70-80% of use. On the basis of the pattern in 2004 (22.9% NHL, 3.2% MCRC, and 3.3% MBC), immunotherapy was associated with $285, $73, and $12 million cost increase for NHL, MCRC, and MBC, respectively. Costs for these cancers would have exceeded $1.82 billion had 50% of eligible patients received immunotherapy.
authors.affiliation: Health Services Research, Department of Biostatistics, Division of Quantitative Sciences, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77230-1402, USA. yashih@mdanderson.org
authors.forename: Ya-Chen Tina
authors.initials: YC
authors.lastname: Shih
authors.forename: Linda S
authors.initials: LS
authors.lastname: Elting
authors.forename: Alexandre L
authors.initials: AL
authors.lastname: Pavluck
authors.forename: Andrew
authors.initials: A
authors.lastname: Stewart
authors.forename: Michael T
authors.initials: MT
authors.lastname: Halpern
mesh_terms: D000911:Antibodies, Monoclonal / Q000191:economics / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000191:economics / Q000276:immunology / Q000556:secondary / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000191:economics / Q000276:immunology / Q000556:secondary / Q000628:therapy*; D016527:Drug Costs / Q000639:trends; D005260:Female; D017048:Health Care Costs / Q000639:trends*; D006801:Humans; D007167:Immunotherapy / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000191:economics / Q000276:immunology / Q000628:therapy*; D008297:Male; D018803:Models, Economic; D010043:Outcome and Process Assessment, Health Care / Q000191:economics* / Q000639:trends; D017410:Practice Guidelines as Topic; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D000911:Antibodies, Monoclonal