Economic burden of dermatologic adverse events induced by molecularly targeted cancer agents

Objective: To report the financial impact of diagnosing and treating the dermatologic toxicities (dTs) that develop in patients receiving targeted anticancer therapies. Design: Single-center retrospective and prospective medical record data extraction. Setting: Department of Dermatology, Northwestern University, Chicago, Illinois. Patients: One hundred thirty-two adults who presented between November 1, 2005, and June 30, 2008, and who were diagnosed as having 1 primary cancer type and were treated with 1 molecularly targeted agent. Main Outcome Measure: Standard billable costs to the patient for dT-related medications, clinic visits, laboratory and diagnostic testing, and therapeutic procedures. Results: The 132 patients had a median of 3 clinic visits for dT management with a median cost of $1920 per patient. Sorafenib was associated with the most costly overall median cost per patient ($2509 per patient), and imatinib was associated with the least costly overall median cost per patient ($1263 per patient). Among the 7 targeted drugs and all 10 dTs, the most costly dT (measured by cost of treatment with medications) was hand/ foot skin reaction, associated with sorafenib therapy (median cost, $968 per patient) (P<.001). The second most costly dT was panitumumab-associated acneiform eruption (median cost, $933 per patient) (P<.001). Conclusion: The cost of diagnosis and treatment of dTs associated with targeted agents contributes to the overall economic burden of cancer care. Efforts toward the prevention of dTs may be important for decreasing the financial burden in oncology.