Patterns of use of systemic therapies among patients with metastatic melanoma: a retrospective claims database analysis in the United States

J Dermatolog Treat. 2017 Sep;28(6):549-553. doi: 10.1080/09546634.2016.1277176. Epub 2017 Jan 19.

Abstract

Objectives: This retrospective analysis of the IMS PharMetrics Plus claims database aimed to describe the current real-world treatment patterns for metastatic melanoma in the USA.

Methods: Included patients (aged ≥18 years) had ≥1 prescription for ipilimumab, vemurafenib, temozolomide or dacarbazine between 1 January 2011 and 31 August 2013; diagnosis of melanoma and metastasis before first use (index date); no index drug use prior to the index date; continuous health plan enrollment for ≥6 months before and ≥3 months after index date. Proportion of days covered (PDC) was defined as days exposed to index therapy divided by continuously enrolled days between index date and last prescription date.

Results: Overall, 1043 patients were included (median age 57 years, 63% male), of whom 39% received the index drug ipilimumab, 35% vemurafenib, 19% temozolomide and 7% dacarbazine. Mean treatment duration (days) was 174 (vemurafenib), 100 (temozolomide) and 64 (dacarbazine). Mean PDC was 81% (vemurafenib), 67% (temozolomide) and 51% (dacarbazine). For patients receiving ipilimumab, 58% had the full 4 doses, 20% 3 doses, 14% 2 doses and 9% 1 dose only for the first induction course; 4% received re-induction, and none had a second re-induction.

Conclusions: This study provides insights into the treatment patterns for metastatic melanoma, including newer agents, in real-world clinical practice.

Keywords: Ipilimumab; dacarbazine; temozolomide; vemurafenib.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Dacarbazine / analogs & derivatives
  • Dacarbazine / therapeutic use
  • Databases, Factual
  • Female
  • Humans
  • Indoles / therapeutic use
  • Insurance Claim Review
  • Ipilimumab / therapeutic use
  • Male
  • Melanoma / drug therapy*
  • Melanoma / pathology
  • Middle Aged
  • Neoplasm Metastasis
  • Retrospective Studies
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / pathology
  • Sulfonamides / therapeutic use
  • Temozolomide
  • United States
  • Vemurafenib
  • Young Adult

Substances

  • Antineoplastic Agents
  • Indoles
  • Ipilimumab
  • Sulfonamides
  • Vemurafenib
  • Dacarbazine
  • Temozolomide