Abstract P5-20-15: Dosing patterns and economic burden of drug wastage among postmenopausal women with HR+/HER2- metastatic breast cancer receiving palbociclib
Notice bibliographique
Résumé
Abstract Background: Dose modification related to adverse event is common in the treatment of metastatic breast cancer (mBC). Based on the dosage form and strengths available, dose modification may lead to drug wastage when the dose cannot be split or saved for later use. This study aimed to describe dosing patterns and to estimate the economic burden of drug wastage associated with dose modifications in postmenopausal women with HR+/HER2- mBC receiving palbociclib. Methods: Postmenopausal adult women diagnosed with HR+/HER2- mBC were identified from the Truven administrative claims database (2006Q1–2015Q4). Regimens received following mBC diagnosis were identified – patients who received a palbociclib-based regimen during one of their first three lines of therapy for mBC were included in the study. Palbociclib starting daily dose, average daily dose, and dosing patterns (dosing modifications and sequences) were reported. A dose modification was defined as a change (decrease/increase) of ≥25mg daily compared to the preceding dose. The economic burden of drug wastage was estimated by multiplying the number of days with drug wastage (i.e., days with overlapping palbociclib prescriptions due to dosage change) by the average cost reimbursed by payers for one unit of palbociclib. Descriptive analyses were conducted separately by line of therapy for mBC. Results: A total of 473 patients received palbociclib in first (214), second (157), or third (120) line of therapy for mBC. Patients were observed to receive palbociclib for an average of 4.3 months in first line and 4.1 months in second and third line of therapy. The majority of patients started palbociclib on the recommended 125 mg dose and remained on that dose until the end of observation. Dosing patterns and sequences are summarized in Table 1. Among the 214 patients who used palbociclib in first line, 38 (17.8%) had a dose modification – among these, 6 (15.8%) patients had an overlap in prescription fills (average overlap of 9.2 days). This potential drug wastage resulted in an average cost of $4,376 per patient over a period of approximately 4 months following treatment initiation. Results were consistent in second and third lines of therapy, with higher proportions of patients with drug wastage in later lines of therapy. Conclusion: Over a short observation period, dose modifications, mostly dose reductions, were relatively frequent, and potential resulting drug wastage was associated with a substantial economic burden. Table 1: Palbociclib dosing patterns and sequences First lineSecond lineThird lineStarting dose (mg daily), N (%) 757 (3.3)3 (1.9)3 (2.5)10015 (7.0)17 (10.8)4 (3.3)125 - recommended dose192 (89.7)137 (87.3)113 (94.2)Average dose on treatment, mean±SD [median]119.52±11.27 [125]115.95±13.61 [125]116.85±13.30 [125]Dose sequencing (mg daily), N (%) 125163 (76.2)96 (61.1)74 (61.7)125→10021 (9.8)29 (18.5)26 (21.7)125→100→756 (2.8)8 (5.1)7 (5.8)125→100→1250 (0.0)1 (0.6)1 (0.8)125→752 (0.9)3 (1.9)4 (3.3)125→75→1000 (0.0)0 (0.0)1 (0.8)10010 (4.7)9 (5.7)1 (0.8)100→752 (0.9)7 (4.5)3 (2.5)100→1253 (1.4)0 (0.0)0 (0.0)100→75→1000 (0.0)1 (0.6)0 (0.0)753 (1.4)3 (1.9)3 (2.5)75→1002 (0.9)0 (0.0)0 (0.0)75→100→1251 (0.5)0 (0.0)0 (0.0)75→1251 (0.5)0 (0.0)0 (0.0) Citation Format: Dalal AA, Gagnon-Sanschagrin P, Burne R, Guerin A, Gauthier G, Small T, Niravath P. Dosing patterns and economic burden of drug wastage among postmenopausal women with HR+/HER2- metastatic breast cancer receiving palbociclib [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-20-15.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».