The direct financial costs of managing adverse events (AEs) associated with systemic therapies for patients with advanced melanoma are significant, according to a study published in Medicine

There are various treatment modalities for advanced melanoma, including chemotherapy, interleukin-2, interferon, and biochemotherapies, each associated with separate safety profiles. The financial burden associated with managing these AEs have not been fully explored. 

For this systematic literature review, researchers identified 7 economic studies conducted between 2007 and 2017 that evaluated the cost of AEs among patients with advanced melanoma. Selected studies assessed direct costs and healthcare resource utilization, including hospitalizations, medication use, and physician visits. The studies were done in multiple countries, and primarily assessed the estimated costs for grade 3 to 4 adverse events. 

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In a US study, results showed that monthly costs for AE management accounted for 36.9% of overall healthcare costs for dacarbazine, 30.3% for paclitaxel, 9.2% for temozolomide, 6.4% for vemurafenib, and 4.0% for ipilimumab. 

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A multicountry study revealed that grade 3 to 4 AEs associated with the greatest cost per event were ipilimumab-associated colitis (Australia, France) and diarrhea (United Kingdom), and chemotherapy-induced neutropenia/leukopenia (Germany, Italy). 

Overall, the most significant source of financial burden for AEs were hospitalizations and use of outpatient medications/procedures, such as erythropoietin and blood transfusions for anemia. 

The authors concluded that “the costs of managing each AE associated with the treatment of advanced melanoma are substantial but may be reduced by effective treatments with improved safety profiles.”


Copley-Merriman C, Stevinson K, Liu FX, et al. Direct costs associated with adverse events of systemic therapies for advanced melanoma: Systematic literature reviewMedicine. 2018;97(31):e11736.