Mapping the treatment pathway for metastatic uveal melanoma patients in England: A qualitative pilot study

Metastatic uveal melanoma (mUM) is a rare disease, and with few effective therapeutic options it is unclear what patients receive as standard of care. Based on national guidelines, we mapped out real-world patient pathways with clinical experts across regional and supra-regional centres across England, to inform a consensus pathway of care following mUM diagnosis.

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Adams E, Cheng CY, Sacco J, et. al.  Mapping the treatment pathway for metastatic uveal melanoma (mUM) patients in England: A qualitative pilot study. Society for Immunotherapy of Cancer’s 32nd Annual Meeting. 8-10 November 2017, National Harbour, Maryland, USA.

 

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Using real world evidence to characterise a cohort of metastatic uveal melanoma patients in England

We identified a cohort of uveal melanoma (UM) and metastatic uveal melanoma (mUM) patients within England using the Hospital Episodes Statistics database, which had similar characteristics to other cohorts identified in the clinical literature.

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Schwenkglenks M, Alamgir G, Cheng CY, et al. A real world evidence (RWE) approach to characterising an ultra-rare disease (URD) cohort of metastatic uveal melanoma (mUM) patients within National Health Service England (NHSE). International Society for Pharmacoeconomics and Outcomes Annual European Congress. 4-8 November 2017. Glasgow, Scotland, UK.

 

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Quantifying standard of care hospital-related resource utilisation for metastatic uveal melanoma patients in England

We assessed the hospital resource use of a cohort of patient with uveal melanoma and metastatic uveal melanoma identified in the Hospital Episode Statistics in England. This showed differences in where patients receive care before and after they develop metastatic disease, indicated a high burden on health care services, and significant travel distances for patients receiving care.

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Cheng CY, Alamgir G, Adams EJ, et al. Quantifying standard of care (SoC) hospital-related resource utilisation for metastatic  uveal melanoma (mUM) patients in NHS England (NHSE) using the Hospital Episodes Statistics (HES) dataset. International Society for Pharmacoeconomics and Outcomes Annual European Congress. 4-8 November 2017. Glasgow, Scotland, UK.

 

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Mapping the diagnostic pathway for breast cancer in England and comparison to Europe

Breast cancer is the most common cancer in women in England and the second most common cause of cancer death. We mapped the breast cancer diagnostic pathway in England and rest of Europe and estimated the number of women transitioning through each step of the pathway, and the number of symptomatic women. We propose a new metric to discuss breast cancer screening, annual effective screening rate, to allow for comparison of the effectiveness of different breast cancer interventions across Europe.

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Adams EJ, Midha D, Glover R,  et al.
Mapping the diagnostic pathway for breast cancer in England and comparison to Europe ISPOR 18th Annual European Congress. 7-11 November 2015. Milan, Italy.

 

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Cervical screening and HPV testing: Opportunities for rapid tests

Problem:  Our client Cepheid has developed a rapid HPV PCR test that can be used as a point-of-care test (POCT). They wanted to understand where in the cervical cancer screening and treatment pathway the test would be most beneficial to patients and the healthcare system. This comes during a time of uncertainty about how best to screen women, and how to organise laboratory services around screening. It is also unclear how screening may differ across Europe and the burden of cervical disease.

 Approach:  We conducted a literature review of the evidence about the current national cervical screening programme in the UK. Then, we conducted 25 semi-structured interviews with key opinion leaders across the UK to gain additional insight about the pathway and the opportunities for using a POCT in the screening pathway. Results also contributed to a European tool to understand cervical cancer diagnosis and burden.

 Impact:  We have presented our findings at international conferences (EUROGIN 2015, IPC 2015), and results have helped our client as they communicate the opportunities and value of a POCT for HPV to their stakeholders and customers. We have engaged with the international community on the requirements for the creation of a standardised international cervical cancer data repository, to inform better evidence-based decision making.

 

Testimonial

“While perfectly responding to the originally given mission, the Aquarius team painted a comprehensive picture of how healthcare is really delivered currently in Europe. This opened up our minds to new ways of improving patient care. The Aquarius team under Elisabeth’s leadership is highly professional, very creative and great fun to work with, without ever taking short cuts. I cannot imagine better results for us.”

  • Dr Anne Postulka, Senior Director Medical & Economic Value, Cepheid

 

Related publications

presentation_iconAdams EJ, Glover R, Vecino A, Postulka A. Exploring the value of a rapid, on-demand test for the detection of human papillomavirus. 30th International Papillomavirus Conference. Lisbon, Portugal. September 17 -21, 2015.

 

presentation_iconAdams EJ, Glover R, Vecino A, Postulka A. How can European countries improve cervical cancer prevention for women? 30th International Papillomavirus Conference. Lisbon, Portugal. September 17 -21, 2015.

How can European countries improve cervical cancer prevention for women?

We conducted a literature review on cervical cancer incidence, screening algorithms and coverage across Europe. Data on the structure and provision of screening programmes are sparse, with large heterogeneity reported by sources. A lack of comparable data across countries makes it challenging for researchers and policy-makers to assess screening effectiveness and what is most beneficial for women. A central data repository could facilitate effectiveness and cost-effectiveness analyses to support the adoption of the best screening algorithm.

presentation_iconAdams EJ, Glover R, Vecino A, Postulka A. How can European countries improve cervical cancer prevention for women? 30th International Papillomavirus Conference. Lisbon, Portugal. September 17 -21, 2015.

 

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Exploring the value of a rapid, on-demand test for the detection of human papillomavirus

We explored the use of a rapid, on-demand human papillomavirus (HPV) test as part of a cervical screening programme. Through semi-structured interviews with experts from across the UK, we found that a co-located, laboratory-based, and on-demand HPV test following cytology could reduce the time to results by up to a week, whilst a near-patient test under primary HPV screening followed by cytology triage could radically change the testing paradigm, with most women notified the same day.

presentation_iconAdams EJ, Glover R, Vecino A, Postulka A. Exploring the value of a rapid, on-demand test for the detection of human papillomavirus. 30th International Papillomavirus Conference. Lisbon, Portugal. September 17 -21, 2015.

 

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