Advanced Device Improves Health and Saves Costs for Patients with Lymphedema

“Lymphedema patients saw a nearly 80 percent reduction in their cellulitis episodes just by using an advanced pneumatic compression device at home, according to a study in JAMA Dermatology co-authored by Vanderbilt University School of Nursing Professor Sheila Ridner, PhD, MSHSA, FAAN, and University of Minnesota School of Public Health Associate Professor Pinar Karaca-Mandic, PhD.

“The reduction in episodes also led to a 37 percent reduction in lymphedema-related health care costs for study participants, Ridner said.

” ‘This could be a game-changer in the area of lymphedema care,’ said Ridner. ‘Up to 10 million people in the United States are living and oftentimes suffering with symptoms of lymphedema. The idea that a home advanced pneumatic compression device can provide relief, decrease the number of cellulitis episodes and save money is an important new option for patients.’ “


Pertuzumab Not Cost Effective in Metastatic HER2-Positive Breast Cancer

“Though the addition of pertuzumab to docetaxel and trastuzumab as first-line therapy for HER2-positive breast cancer has been shown to yield a substantial survival benefit, a new analysis shows that there is very little chance that pertuzumab would be cost effective in the United States.

“The CLEOPATRA trial showed that pertuzumab along with docetaxel and trastuzumab (THP) resulted in a median survival in HER2-positive metastatic breast cancer patients of 56.5 months, compared with only 40.8 months for the latter two drugs alone (TH). ‘These exceptional results come at a price,’ wrote researchers led by Ben Y. Durkee, MD, PhD, of Stanford University in California. ‘Our work shows that an insurer could expect to pay $4,649 per week for the THP regimen at Medicare rates. Private contractors and smaller entities would pay more.’

“The researchers used a decision-analytic Markov model to evaluate the regimen’s cost effectiveness, based on the study population from CLEOPATRA and the assumed number of patients for whom the THP regimen would be recommended in the metastatic setting. Results were published online ahead of print in the Journal of Clinical Oncology.”


An 'Utterly Broken' Drug Market: The High Cost of Surviving Cancer

“Lauren Baumann is one of the lucky ones.

“Though she has cancer, chronic myeloid leukemia, it is manageable, as long as she takes a daily pill called Gleevec. Gleevec is considered a wonder drug, turning Lauren’s leukemia from a death sentence to a disease she and thousands of others can live with. The problem is, even with health insurance and a full-time job, Lauren can’t afford the monthly co-pay for Gleevec. It can be as high as $2,000 a month — twice the average mortgage payment in the U.S.

” ‘I feel like you get punished,’ says Baumann. ‘I didn’t ask to get cancer; I didn’t ask to get sick. I was 26 and I was perfectly healthy.’ “


The People Who Brought You Cheaper Hepatitis C Drugs Are Going After Cancer Next

“Express Scripts Holding Co., which this year forced price concessions from makers of $1,000-a-day hepatitis C medicines, has set its sights on $37 billion in U.S. spending on cancer medications. Its goal is to start influencing the drugs’ costs as soon as next year.

“Express Scripts is the country’s biggest manager of prescription drug benefits. However, its reach doesn’t extend to many injected or infused cancer drugs administered in doctors’ offices and hospitals, not dispensed in retail pharmacies. The St. Louis-based company’s ambition is to change that, including eventually for new drugs that trigger the body’s own immune system to attack tumors and can cost $150,000.

“ ‘We want to be able to start influencing the market by 2016,’ said Steve Miller, Express Scripts’ chief medical officer, in an interview at Bloomberg’s offices in New York. ‘We are accumulating all the keys to the puzzle to be able to do this.’ ”


Proton Therapy Shown to be Less Costly than Some Alternative Radiotherapy Techniques

“In terms of duration of treatment and cost, patients with early stage breast cancer may benefit from accelerated partial breast irradiation (APBI) with proton therapy versus whole breast irradiation (WBI), according to new research from The University of Texas MD Anderson Proton Therapy Center.

“In a cost analysis study based on typical patient characteristics, researchers used Medicare reimbursement codes to analyze allowable charges for eight different types of partial and whole breast irradiation therapies and treatment schedules available to early stage breast cancer patients. Taken together, these represent roughly 98% of the treatment options available to these patients. The cost of proton therapy when used for APBI, introduced to decrease overall treatment time and toxicity, was estimated at $13,833. Comparatively, WBI using IMRT (x-ray) therapy resulted in the highest Medicare charges at $19,599. The average charges across the eight treatment regimens were $12,784; thus, proton costs were similar to that of other types of radiation.

“The findings were presented at the inaugural North America meeting of the Particle Therapy Co-Operative Group (PTCOG) held at MD Anderson Proton Therapy Center. A manuscript detailing the study findings is underway.”


EML4-ALK Fusion Testing, Targeted Crizotinib Treatment Not Cost-Effective in NSCLC

“EML4-ALK fusion testing to identify patients with advanced non–small cell lung cancer eligible for first-line, targeted treatment with crizotinib may not be cost-effective, according to study results.

“Researchers in Ontario used a Markov model to compare the cost-effectiveness of two treatment approaches for patients with stage IV nonsquamous NSCLC. One approach consisted of molecular screening and targeted treatment with crizotinib (Xalkori, Pfizer). The other approach consisted of standard care, which included platinum doublet (cisplatin and gemcitabine) as first-line therapy, second-line pemetrexed (Alimta, Eli Lilly) and third-line erlotinib (Tarceva; Genentech, Astellas Pharma).”

Editor’s Note: Molecular testing can be used to identify genetic mutations in a patient’s tumor that may point to the use of a certain treatment, personalized for him or her. This study explores the costs associated with these treatments. Of course, every patient’s treatment decisions will be made for his or her own personal reasons. You can talk to your doctor to find out if molecular testing and targeted therapies are good choices for you.