Immunotherapy and Targeted Therapy Increase Melanoma Survival and Health Care Burden
Source: Dermatology Advisor, October 2023
Among patients with invasive melanoma, improvements in overall survival (OS) rates due to the adoption of immunotherapy and targeted systemic therapies are further associated with greater economic and time burdens on the health care system, according to study results published in the Journal of the American Medical Association Dermatology.
Investigators in Ontario, Canada conducted a retrospective cohort study to evaluate changes in patients’ OS, time toxicity, and health care costs — in Canadian dollars — associated with the recent adoption of palliative and adjuvant immunotherapy and targeted therapies for the treatment of melanoma. Patients diagnosed with melanoma from 2007 to 2021 were matched 1:1 to patients diagnosed with melanoma from 2018 to 2019. OS was measured from diagnosis to death or last follow-up. Time toxicity was defined as in-person days with health care-related visits, including hospitalizations, day operations, emergency department-only visits, long-term care stays, and outpatient care visits. To estimate and measure propensity scores (PS) and comorbidities, the investigators used a logistic regression model with demographic covariates, melanoma characteristics, and the Elixhauser comorbidity index score, respectively. The OS rate was assessed using the Kaplan-Meier method.
The primary outcomes were mean per-capita health care and systemic therapy (minimum 1 dose of oral or intravenous systemic treatment) costs during 1-year postdiagnosis, time toxicity within 1 year of initial treatment, and OS.