Healthcare Resources Utilization (HCRU) and Exploration of the Patient Journey through Claims Database: An Application on Advanced Renal Cell Carcinoma (ARCC) Patients in France

Speaker(s)

Durand Zaleski I1, Albigès L2, Branchoux S3, Lemasson H4, Gouverneur A5, Chenuc G5, Néré S3, Gaudin AF6, Négrier S7, Bellera C8
1Professor of Public Health Medicine and Doctor of Economics. Director of URCEco, Paris, Ile-de-France, France, 2Institu Gustave Roussy, Paris, France, 3Bristol Myers Squibb, RUEIL MALMAISON, France, 4Bristol-Myers Squibb SARL, RUEIL MALMAISON, France, 5IQVIA, Real World Solutions, Bordeaux, France, 6Bristol Myers Squibb, Rueil-Malmaison, France, 7Centre Léon Bérard, University of Lyon, Lyon, France, 8Epicene Team (Cancer & Environnement), Bordeaux Population Health Center, ISPED, Centre INSERM U1219, Bordeaux, France

Presentation Documents

OBJECTIVES: In 2016, second-line (2L) aRCC treatment changed significantly in France with the availability of immunotherapy, impacting the care journey. The study objective was to describe real-world HCRU of 2L aRCC patients and the care journeys according to the 2L treatment.

METHODS: An observational retrospective cohort study was performed using the French Public Health comprehensive claims database (SNDS). All aRCC patients aged ≥18 years and initiating a first-line systemic treatment in 2016 were followed until death, loss to follow-up, or 31-Dec-2019. Patients initiating 2L treatment were selected. Kaplan-Meier approach was applied to estimate treatment duration. All hospital and ambulatory HCRU during the 2L period were described over the treatment period and on a per month basis.

RESULTS: Among the 1,629 first-line patients, 872 patients initiated a 2L treatment during the follow-up period, mainly with nivolumab (43.7%) and tyrosine kinase inhibitor (TKI) (42.2%). Median treatment duration was 5.1 and 4.9 months for nivolumab and TKI, respectively; 93% of nivolumab patients received the treatment at least once in inpatient sessions. Patients also had other hospital HCRU in both care journeys (nivolumab and TKI): 56% and 65% of patients with one or more hospital physician consultations, 55% and 40% of patients with at least one inpatient hospitalization, 34% and 37% with at least one emergency visit. These monthly proportions remained stable during the treatment period, except for a reduction in complete hospitalizations. Patients frequently used ambulatory care in both care journeys: per month of treatment, 28% to 46% of patients had at least one visit to general practitioner, 79% to 98% a retail pharmacist visit, 46% to 74% nurse care.

CONCLUSIONS: This study is the first to describe the aRCC care journey in France. It highlights the importance of hospital HRCU regardless of treatment received, and the significant role of nurses and retail pharmacists in ambulatory setting.

Code

HSD117

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, Oncology