1
|
Zrubka Z, Péntek M, Mhanna L, Abu-Zahra T, Mahdi-Abid M, Fgaier M, El-Dahiyat F, Al-Abdulkarim H, Drummond M, Gulácsi L. Disease-Related Costs Published in The Middle East and North Africa Region: Systematic Review and Analysis of Transferability. Pharmacoeconomics 2022; 40:587-599. [PMID: 35578009 PMCID: PMC9130178 DOI: 10.1007/s40273-022-01146-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In the Middle East and North Africa (MENA) the scarcity of local cost data is a key barrier to conducting health economic evaluations. We systematically reviewed reports of disease-related costs from MENA and analysed their transferability within the region. METHODS We searched PubMed and included full text English papers that reported disease-related costs from the local populations of Algeria, Bahrain, Egypt, Iraq, Jordan, Saudi Arabia, Kuwait, Lebanon, Libya, Morocco, Oman, Palestine, Qatar, Syria, Tunisia, United Arab Emirates and Yemen between 1995 and 2019. Screening, study selection and data extraction were done in duplicate. Study-related variables, costing methods, all costs and their characteristics were extracted and analysed via descriptive methods. From multi-country studies of MENA employing homogenous costing methods, we estimated the ratio (cost transfer coefficient) between the relative differences in direct medical costs and macroeconomic indicators via robust regression. We predicted each cost via the estimated cost transfer formula and evaluated prediction error between true and predicted (transferred) costs. RESULTS The search yielded 1646 records, 206 full text papers and 3525 costs from 84 diagnoses. Transferability was analysed involving 144 direct medical costs from eight multi-country studies. Adjusting the average of available foreign costs by 0.28 times the relative difference in GDP per capita provided the most accurate estimates. The correlation between true and predicted costs was 0.96; 68% of predicted costs fell in the true ± 50% range. Predictions were more accurate for costs from studies that involved the largest number of countries, for countries outside the Gulf region and for drug costs versus unit or disease costs. CONCLUSION The estimated cost transfer formula allows the prediction of missing costs in MENA if only GDP per capita is available for adjustment to the local setting. Input costs for the formula should be collected from multiple sources and match the decision situation.
Collapse
Affiliation(s)
- Zsombor Zrubka
- Health Economics Research Center, University Research and Innovation Center, Óbuda University Budapest, Óbudai Egyetem, Bécsi út 96, Budapest, 1034 Hungary
- Corvinus Institute for Advanced Studies, Corvinus University of Budapest, Budapest, Hungary
| | - Márta Péntek
- Health Economics Research Center, University Research and Innovation Center, Óbuda University Budapest, Óbudai Egyetem, Bécsi út 96, Budapest, 1034 Hungary
| | - Lea Mhanna
- Doctoral School of Applied Informatics and Applied Mathematics, Óbuda University, Budapest, Hungary
| | - Teebah Abu-Zahra
- Health Policy and Financing Masters Course, Corvinus University of Budapest, Budapest, Hungary
| | - Mohamed Mahdi-Abid
- Research Center of Epidemiology and Statistics, Paris University, Paris, France
| | - Meriem Fgaier
- Doctoral School of Applied Informatics and Applied Mathematics, Óbuda University, Budapest, Hungary
| | - Faris El-Dahiyat
- College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
| | - Hana Al-Abdulkarim
- Doctoral School of Applied Informatics and Applied Mathematics, Óbuda University, Budapest, Hungary
- Drug Policy and Economic Center, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | | | - László Gulácsi
- Health Economics Research Center, University Research and Innovation Center, Óbuda University Budapest, Óbudai Egyetem, Bécsi út 96, Budapest, 1034 Hungary
- Corvinus Institute for Advanced Studies, Corvinus University of Budapest, Budapest, Hungary
| |
Collapse
|
3
|
Mazieres J, Drilon A, Lusque A, Mhanna L, Cortot AB, Mezquita L, Thai AA, Mascaux C, Couraud S, Veillon R, Van den Heuvel M, Neal J, Peled N, Früh M, Ng TL, Gounant V, Popat S, Diebold J, Sabari J, Zhu VW, Rothschild SI, Bironzo P, Martinez-Marti A, Curioni-Fontecedro A, Rosell R, Lattuca-Truc M, Wiesweg M, Besse B, Solomon B, Barlesi F, Schouten RD, Wakelee H, Camidge DR, Zalcman G, Novello S, Ou SI, Milia J, Gautschi O. Immune checkpoint inhibitors for patients with advanced lung cancer and oncogenic driver alterations: results from the IMMUNOTARGET registry. Ann Oncol 2020; 30:1321-1328. [PMID: 31125062 PMCID: PMC7389252 DOI: 10.1093/annonc/mdz167] [Citation(s) in RCA: 759] [Impact Index Per Article: 189.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Anti-PD1/PD-L1 directed immune checkpoint inhibitors (ICI) are widely used to treat patients with advanced non-small-cell lung cancer (NSCLC). The activity of ICI across NSCLC harboring oncogenic alterations is poorly characterized. The aim of our study was to address the efficacy of ICI in the context of oncogenic addiction. Patients and methods We conducted a retrospective study for patients receiving ICI monotherapy for advanced NSCLC with at least one oncogenic driver alteration. Anonymized data were evaluated for clinicopathologic characteristics and outcomes for ICI therapy: best response (RECIST 1.1), progression-free survival (PFS), and overall survival (OS) from ICI initiation. The primary end point was PFS under ICI. Secondary end points were best response (RECIST 1.1) and OS from ICI initiation. Results We studied 551 patients treated in 24 centers from 10 countries. The molecular alterations involved KRAS (n = 271), EGFR (n = 125), BRAF (n = 43), MET (n = 36), HER2 (n = 29), ALK (n = 23), RET (n = 16), ROS1 (n = 7), and multiple drivers (n = 1). Median age was 60 years, gender ratio was 1 : 1, never/former/current smokers were 28%/51%/21%, respectively, and the majority of tumors were adenocarcinoma. The objective response rate by driver alteration was: KRAS = 26%, BRAF = 24%, ROS1 = 17%, MET = 16%, EGFR = 12%, HER2 = 7%, RET = 6%, and ALK = 0%. In the entire cohort, median PFS was 2.8 months, OS 13.3 months, and the best response rate 19%. In a subgroup analysis, median PFS (in months) was 2.1 for EGFR, 3.2 for KRAS, 2.5 for ALK, 3.1 for BRAF, 2.5 for HER2, 2.1 for RET, and 3.4 for MET. In certain subgroups, PFS was positively associated with PD-L1 expression (KRAS, EGFR) and with smoking status (BRAF, HER2). Conclusions : ICI induced regression in some tumors with actionable driver alterations, but clinical activity was lower compared with the KRAS group and the lack of response in the ALK group was notable. Patients with actionable tumor alterations should receive targeted therapies and chemotherapy before considering immunotherapy as a single agent.
Collapse
Affiliation(s)
- J Mazieres
- Thoracic Oncology Department, Toulouse University Hospital, Université Paul Sabatier, Toulouse, France.
| | - A Drilon
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - A Lusque
- Biostatistics Unit, Institut Claudius Regaud, IUCT-O, Toulouse
| | - L Mhanna
- Thoracic Oncology Department, Toulouse University Hospital, Université Paul Sabatier, Toulouse, France
| | - A B Cortot
- Thoracic Oncology Department, Lille University Hospital, Lille University, Lille
| | - L Mezquita
- Cancer Medicine Department, Gustave Roussy, Villejuif, Paris Sud University Orsay, Paris France
| | - A A Thai
- Medical Oncology Department, Peter MacCallum Cancer Institute, Melbourne, Australia
| | - C Mascaux
- Multidisciplinary Oncology and Therapeutic Innovations Department, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, CNRS, INSERM, CRCM, Marseille
| | - S Couraud
- Respiratory Diseases and Thoracic Oncology Department, Lyon Sud Hospital, Cancer Institute of Hospices Civils de Lyon, Lyon 1 University
| | - R Veillon
- CHU Bordeaux, Respiratory Diseases Department, Bordeaux, France
| | - M Van den Heuvel
- Faculty of Medical Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Neal
- Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University, Stanford, USA
| | - N Peled
- Soroka Medical Center, Ben-Gurion University, Beer-Sheva, Israel
| | - M Früh
- Department of Oncology, Haematology, Cantonal Hospital St Gallen, St Gallen, University of Bern, Switzerland
| | - T L Ng
- Thoracic Oncology Department, University of Colorado Cancer Center, Aurora, USA
| | - V Gounant
- Department of Thoracic Oncology, CIC1425-CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - S Popat
- Royal Marsden Hospital, London, UK
| | - J Diebold
- Cantonal Hospital, Lucerne, Switzerland
| | - J Sabari
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - V W Zhu
- Department of Medicine, Division of Hematology-Oncology, University of California, Irvine School of Medicine, Orange, USA
| | - S I Rothschild
- Department Internal Medicine, University Hospital Basel, Medical Oncology, Basel, Switzerland
| | - P Bironzo
- Department of Oncology, University of Torino, Torino, Italy
| | - A Martinez-Marti
- Medical Oncology Department, Vall d'Hebron Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | - R Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - M Lattuca-Truc
- Pulmonology Department, Grenoble University Hospital, Grenoble, France
| | - M Wiesweg
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - B Besse
- Cancer Medicine Department, Gustave Roussy, Villejuif, Paris Sud University Orsay, Paris France
| | - B Solomon
- Medical Oncology Department, Peter MacCallum Cancer Institute, Melbourne, Australia
| | - F Barlesi
- Multidisciplinary Oncology and Therapeutic Innovations Department, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, CNRS, INSERM, CRCM, Marseille
| | - R D Schouten
- Faculty of Medical Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - H Wakelee
- Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University, Stanford, USA
| | - D R Camidge
- Thoracic Oncology Department, University of Colorado Cancer Center, Aurora, USA
| | - G Zalcman
- Department of Thoracic Oncology, CIC1425-CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - S Novello
- Department of Oncology, University of Torino, Torino, Italy
| | - S I Ou
- Department of Medicine, Division of Hematology-Oncology, University of California, Irvine School of Medicine, Orange, USA
| | - J Milia
- Thoracic Oncology Department, Toulouse University Hospital, Université Paul Sabatier, Toulouse, France
| | - O Gautschi
- University of Bern and Cantonal Hospital, Lucerne, Switzerland
| |
Collapse
|
6
|
Mhanna L, Noel-Savina E, Pontier S, Jaffro M, Guibert N, Hermant C, Plat G, Didier A. [Use of endobronchial ultrasound in the management of cryptogenic haemoptysis]. Rev Mal Respir 2017; 34:770-773. [PMID: 28867308 DOI: 10.1016/j.rmr.2016.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 12/16/2016] [Indexed: 11/17/2022]
Abstract
Currently about 50% of cases of haemoptysis are thought to be cryptogenic. Haemorrhage from the pulmonary arterial system is rare and usually due to aneurysms or pseudoaneurysms, the radiological diagnosis of which is often difficult. We report here the case of a patient admitted with a heavy haemoptysis in whom the thoracic CT scan did not reveal the diagnosis. Bronchoscopy with endobronchial ultrasound showed a vascular malformation of a branch of the pulmonary artery allowing a radiological embolisation. This case underlines the importance of bronchoscopy and the role of ultrasound in the diagnosis of haemoptysis, considered ideopathic, complicating vascular malformations.
Collapse
Affiliation(s)
- L Mhanna
- Pôle des voies respiratoires, service de pneumologie-allergologie, hôpital Larrey, CHU de Toulouse, université Paul-Sabatier, chemin de Pouvourville, 31059 Toulouse cedex, France
| | - E Noel-Savina
- Pôle des voies respiratoires, service de pneumologie-allergologie, hôpital Larrey, CHU de Toulouse, université Paul-Sabatier, chemin de Pouvourville, 31059 Toulouse cedex, France.
| | - S Pontier
- Pôle des voies respiratoires, service de pneumologie-allergologie, hôpital Larrey, CHU de Toulouse, université Paul-Sabatier, chemin de Pouvourville, 31059 Toulouse cedex, France
| | - M Jaffro
- Service de radiologie, centre hospitalier universitaire, université Paul-Sabatier, 31000 Toulouse, France
| | - N Guibert
- Pôle des voies respiratoires, service de pneumologie-allergologie, hôpital Larrey, CHU de Toulouse, université Paul-Sabatier, chemin de Pouvourville, 31059 Toulouse cedex, France
| | - C Hermant
- Pôle des voies respiratoires, service de pneumologie-allergologie, hôpital Larrey, CHU de Toulouse, université Paul-Sabatier, chemin de Pouvourville, 31059 Toulouse cedex, France
| | - G Plat
- Pôle des voies respiratoires, service de pneumologie-allergologie, hôpital Larrey, CHU de Toulouse, université Paul-Sabatier, chemin de Pouvourville, 31059 Toulouse cedex, France
| | - A Didier
- Pôle des voies respiratoires, service de pneumologie-allergologie, hôpital Larrey, CHU de Toulouse, université Paul-Sabatier, chemin de Pouvourville, 31059 Toulouse cedex, France
| |
Collapse
|