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T. Kose
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P2.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 225)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.08-015 - The Relationship between the Cost of Treatment and Prognosis in Malignant Mesothelioma in Turkey (ID 2558)
09:30 - 09:30 | Author(s): T. Kose
- Abstract
Background:
Malignant mesothelioma (MM) is endemic in the population exposed to asbestos and has high healthcare cost with a limited life expectancy. The aim of this study is to evaluate the relationship between cost according to treatment type and prognosis in MM patients followed up from diagnosis to death.
Methods:
The demographics and healthcare costs of 239 patients with MM were obtained from hospital records in the tertiary university hospital between 2005 and 2014. Variance analysis and t-test were performed to compare the groups. The survival rates were estimated using the Kaplan-Meier method. To clarify health care cost in Turkey, the following information was given according to the national reimbursement price in April 2015. This study was supported by General Directorate of Health Researches, Republic of Turkey, Ministry of Health.
Results:
The mean age of the patients were 62.9±11.3 years and 125 (52.3%) of them were male. The median survival time was 9.0±0.8 months (95% CI: 7.3–10.7). Patients’ numbers according to treatment schema: 52 (21.8%) best supportive care (BSC); 3 (1.3%) BSC+palliative radiotherapy (pRT); 117 (49.0%) chemotherapy; 39 (16.3%) chemotherapy+pRT, 16 (6.7%) pleurectomy/decortication (P/D)+chemotherapy+RT; 4 (1.7%) P/D+chemotherapy; 8 (3.3%) extrapleural pneumonectomy (EPP)+chemotherapy+RT. BSC group had the lowest average cost with $1,355 (r:258-4,909) per patient. The average cost was $6,595 (r:1,621-21,371) for patients received only chemotherapy. When pRT added to chemotherapy, cost was increasing to $8,962 per patient. The average cost was $11,691 (r:6,567-19,064) per patient for P/D+chemotherapy+RT group. It decreased to $10,676 without RT. The highest average cost was seen in the group of EPP+chemotherapy+RT with $13,788 (r:6,168-19,577) per patient. The median survival times were 6 months (95%CI:5.3-6.7), 12 months (95%CI:9.8-14.2), 18 months (95%CI:11.5-24.5), 27 months (95%CI:7.6-46.4) for BSC, chemotherapy, P/D+chemotherapy+RT and EPP+chemotherapy+RT group, respectively. The median survival time was significantly different between BSC and chemotherapy groups (Log-Rank:10.607; p=0.001). The average cost of 6 months prolongation of lifetime was $5,239 in chemotherapy group and incremental cost was $873 per month gained. The median survival time was not different between chemotherapy and P/D+chemotherapy+RT groups (Log-Rank: 1.263; p=0.261). However, there was 6 months survival difference between the two groups. The average cost of 6 months prolongation of lifetime was $5,097 and incremental cost was $850 per month gained in EPP+chemotherapy+RT. The median survival time was significantly different between chemotherapy and EPP+chemotherapy+RT groups (Log-Rank: 8.082; p=0.004). The average cost of 15 months prolongation of lifetime was $7,194 and incremental cost was $480 per month gained in EPP+chemotherapy+RT group. There was a difference between surgical groups in terms of median survival (Log-Rank:4.421; p=0.036). The average cost for prolongation of lifetime was $2,097 and incremental cost was $233 per month gained.
Conclusion:
MM has a limited survival time despite antitumor treatment and treatment cost is relatively high by prolongation of lifetime. Treatment should be given to selected patients and EPP should be preferred to P/D as much as possible. It is clear that there is need well designed prospective studies for cost analysis of MM.
