HOUT-11. ECONOMIC IMPACT OF SODIUM THIOSULFATE ON CISPLATIN-INDUCED HEARING LOSS. (5th November 2018)

• Record Type: Journal Article
• Authors: Fu, Rongwei (Rochelle); Knight, Kristin; Freyer, David; Doolittle, Nancy; Brock, Penelope; Neweult, Edward
• Is Part Of: Neuro-oncology. Volume 20(2018)Supplement 6
• Page Start: vi115
• Page End: vi115
• Publication Date: 2018-11-05
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noy148.479
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: BACKGROUND. Cisplatin-induced hearing loss (CIHL) develops in majority of children receiving cisplatin chemotherapy. Recently two phase-3 clinical trials demonstrated effectiveness of sodium thiosulfate (STS) in preventing CIHL. This study quantifies the potential economic impact of STS on cisplatin-treated children with hepatoblastoma (HB) in US. METHODS. We used an incidence-based approach to model CIHL cost for standard risk HB patients 19 yrs. Input data included: 1) estimates of incidence and survival, and age distribution of HB in US; 2) incidence of CIHL and effectiveness of STS; 3) lifelong health care and education cost and lost productivity (up to 65 yrs). Market cost of STS is unknown and not included but expected to be a small part of lifelong cost. When estimating the total and reduced costs, costs of CIHL were calculated by age and degree of CIHL severity (none, mild, severe), and the uncertainty in the input estimates were incorporated through Monte Carlo simulation. RESULTS. For a child diagnosed with HB at 1yr old and developed severe CIHL, the estimated lifelong cost is $825K ($347K health care and education cost; $478K lost productivity). Given an incidence of 0.13 cases per 100, 000 in US, the annual cost of CIHL is estimated to be $16.7 million (95% CI 15.5–17.8). Assuming that all new HB patients receive STS and CIHL is reduced from 70% to 30%, the annual reduced cost in the US would be $1.81million (95% CI 1.29–2.34) after 5 years, $3.60million (95% CI 2.87–4.37) and $6.96million (95% CI 5.98–8.03), respectively, after 10 and 20 years. CONCLUSION. STS treatment could potentially lead to significant reduction in CIHL-related cost to society. Further analyses will evaluate the economic impact of STS on all childhood solid tumors, and include STS cost. Such economic impact will help inform the future clinical role of STS.