Program

In-person AND virtual! – We are pioneering a new conference format that will connect in-person and virtual audiences to create a unique experience. Matching the innovation that comes through our members’ work, ISPOR is pushing the boundaries of innovation to design an event that works in today’s quickly changing environment. 

In-person registration included the full virtual experience, and virtual-only attendees will be able to tune into live in-person sessions and/or watch captured in-person sessions on-demand in addition to having a variety of virtual-only sessions to attend.

Impact of Adherence to Novel Hormonal Therapies on Emergency Department Utilization in Patients with Metastatic Castration-Resistant Prostate Cancer

Speaker(s)

Shukla N1, Barner JC2, Rascati K3, Doshi G4, Park C5, Sohn T3
1The University of Texas at Austin, AUSTIN, TX, USA, 2The University of Texas at Austin College of Pharmacy, Texas Center for Health Outcomes Research and Education (TxCORE), Austin, TX, USA, 3The University of Texas at Austin, Austin, TX, USA, 4US Oncology Network, McKesson Specialty Health, Houston, TX, USA, 5The University of Texas at Austin, Austin, Texas, TX, USA

Objectives: Abiraterone acetate (ABI) and enzalutamide (ENZ) are the first two oral novel hormonal therapies (NHTs) approved for treatment of metastatic castration-resistant prostate cancer (mCRPC). The objectives were to compare prostate cancer (PCa)-related and all-cause emergency department (ED) utilization between ABI and ENZ and examine the impact of demographic and clinical characteristics on ED utilization.

Methods: This study utilized 2013-2017 Humana Medicare medical and prescription claims data and included continuously enrolled (6 months pre- to 12 months post-index) men aged>65 with PCa as the primary cancer, with one inpatient/outpatient PCa diagnosis, and at least one prescription for ABI or ENZ. The index date was the first NHT prescription date. Dependent variables included proportion of men with ≥1 PCa-related and all-cause ED visits. Index NHT type was the primary predictor variable and demographic and clinical characteristics served as covariates. Statistical methods included chi-square tests and multiple logistic regression (MLR).

Results: Among included patients (N=1,254), unadjusted analyses showed no significant differences in PCa-related (23.3% vs. 18.9%) or all-cause (53.5% vs. 49.4%) ED visits between ABI and ENZ. The adjusted MLR model for PCa-related ED visits indicated significantly (p<0.05) lower odds of ≥1 PCa-related ED visits in: 66-70 age group (vs. ≥85), men with lymph node metastases only and other metastases (vs. >1 metastasis), and adherent men (vs. non-adherent). Regarding ≥1 all-cause ED visits, MLR model indicated (p<0.05): lower odds in 66-70, 71-74, and 75-80 age groups (vs. ≥85), men with other metastases (vs. >1 metastasis), and adherent (vs. non-adherent); while higher odds in men with Klabunde Comorbidity Index (NCICI)≥2 (vs. NCICI=0), after controlling for covariates.

Conclusion: While ED utilization was similar between ABI and ENZ, older age groups, greater number of metastases, and non-adherence to NHTs were significantly associated with higher ED utilization. Additional efforts are needed to improve adherence to NHTs.

Code

EE169

Topic

Economic Evaluation, Study Approaches

Disease

Drugs, Oncology