Use of individualized starting dose and niraparib hematologic adverse event management costs in ovarian cancer
<b>Aim:</b> To understand the impact of the niraparib individualized starting dose (ISD), compared with fixed starting dose (FSD), on the cost of hematologic adverse event (AE) management from a US payer perspective. <b>Methods:</b> The frequencies of grade ≥3 hematologic AEs that occurred in >1% of patients treated with niraparib were obtained from the primary analysis results of the phase III PRIMA/ENGOT-OV26/GOG-3012 trial. US unit costs for each grade ≥3 AE in the base case were obtained from the 2017 Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project database; unit costs were adjusted to 2020 US dollars. AE management costs per patient were calculated by multiplying AE unit cost by the frequency of each AE by niraparib starting dose. Because AEs were assumed to occur independently of one another, costs were added to derive the total cost. <b>Results:</b> For niraparib, the estimated AE management cost per patient was lower for the ISD than the FSD for all hematologic AEs (FSD vs ISD: thrombocytopenia, $4701.87 vs $1921.89; anemia, $2784.00 vs $1760.59; platelet count decreased, $2103.47 vs $922.51; neutropenia, $2112.50 vs $1369.56; neutrophil count decreased, $1285.87 vs $770.38). The total mean calculated AE management cost per patient was $12,987.71 with the FSD and $6744.93 with the ISD. <b>Conclusion:</b> For niraparib, the cost of managing hematologic AEs in the US was reduced by almost half with the ISD compared with the FSD. The cost reduction and improvements in safety associated with the niraparib ISD support its use in clinical practice.
Authors
- Bhavana Pothuri (ORCID: https://orcid.org/0000-0003-4578-2061)
- Lyndsay Willmott (ORCID: https://orcid.org/0009-0007-8004-2559)
- Hannelore Denys (ORCID: https://orcid.org/0000-0002-8897-9430)
- Bradley J. Monk (ORCID: https://orcid.org/0000-0001-6985-0159)
- Diane Provencher (ORCID: https://orcid.org/0000-0003-1902-3256)
- David M. O’Malley (ORCID: https://orcid.org/0000-0002-2828-0177)
- Florian Heitz (ORCID: https://orcid.org/0000-0002-2412-0352)
- Ying Zhuo (ORCID: https://orcid.org/0000-0001-8522-0851)
- Ashley Haggerty (ORCID: https://orcid.org/0000-0002-7064-3189)
- Ilan Bruchim
- Luís Manso (ORCID: https://orcid.org/0000-0002-1683-550X)
- Maria-Pilar Barretina-Ginesta (ORCID: https://orcid.org/0000-0003-0074-6614)
- Donna V Booth
- Anna V Tinker
- Antonio González‐Martín (ORCID: https://orcid.org/0000-0003-0276-0778)
- Ignace Vergote (ORCID: https://orcid.org/0000-0002-7589-8981)
- Domenica Lorusso (ORCID: https://orcid.org/0000-0003-0981-0598)
- Purificación Estévez-García (ORCID: https://orcid.org/0000-0002-4813-5145)
- Anja Ør Knudsen (ORCID: https://orcid.org/0009-0002-1871-3087)
- Michel Fabbro (ORCID: https://orcid.org/0000-0003-1910-4777)
- John Hartman
- John K Chan
- Whitney A. Spannuth Graybill (ORCID: https://orcid.org/0009-0009-2347-1853)
- Maarit Anttila
Institutions
- Gynecologic Oncology Group (US)
- Humanitas University (IT)
- University of British Columbia (CA)
- Medical University of South Carolina (US)
- The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US)
- Ghent University Hospital (BE)
- Odense University Hospital (DK)
- Hillel Yaffe Medical Center (IL)
- California Pacific Medical Center (US)
- Humboldt-Universität zu Berlin (DE)
- The European Academy of Gynaecological Surgery (BE)
- Kuopio University Hospital (FI)
- Hospital Universitario 12 De Octubre (ES)
- Institut Català d'Oncologia (ES)
- Institut d'Investigació Biomèdica de Girona (ES)
- GlaxoSmithKline (United States) (US)
- Florida Cancer Specialists & Research Institute (US)
- Kadlec Clinic (US)
- Clinica Universidad de Navarra (ES)
- Institut de Recherche en Cancérologie de Montpellier (FR)
- Centre Hospitalier de l’Université de Montréal (CA)
- Kliniken Essen-Mitte (DE)
- Hackensack Meridian Health (US)
- Hospital Universitario Virgen del Rocío (ES)
- Spanish Ovarian Cancer Research Group (ES)
- Institut Regional du Cancer de Montpellier (FR)
- The Ohio State University (US)
- Charité - Universitätsmedizin Berlin (DE)
Publication Details
- Journal
- Journal of Comparative Effectiveness Research
- Published
- 2024-12-13
- DOI
- https://doi.org/10.57264/cer-2024-0133
- Primary Topic
- PARP inhibition in cancer therapy
- Type
- article
- Field-Weighted Citation Impact
- 0.00