Healthcare Resource Utilization and Economic Burden of Metastatic Pancreatic Cancer: A US Commercial and Medicare Claims Analysis From 2020 to 2023
Author(s)
Kenneth H. Yu, MD1, Adaeze Q. Amaefule, MS, PharmD2, Gergana Georgieva, PharmD, RPh2, Tomomi Kimura, MD, PhD2, Baoguo Jiang, PhD2, Rupali Fuldeore, MS2.
1David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, Ithaca, NY, USA, 2Astellas Pharma Global Development Inc, Northbrook, IL, USA.
1David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, Ithaca, NY, USA, 2Astellas Pharma Global Development Inc, Northbrook, IL, USA.
Presentation Documents
OBJECTIVES: The 5-year relative survival rate (2014-2020) for US patients with pancreatic cancer (PC) was 12.8%. Recent data on the disease burden of metastatic (m) PC is limited. This retrospective study analyzed healthcare resource utilization (HRU), costs, and treatment patterns in these patients.
METHODS: Adult US patients with first mPC diagnosis (index date) between January 1, 2020-December 31, 2022 were identified in the Merative MarketScan database. Mean all-cause inpatient, outpatient, and emergency room [ER] visits and costs in USD for 1 year from index date were estimated as per-person-per-month (PPPM). First-line treatments started ≤90 days from index date were categorized as FOLFIRINOX-based, gemcitabine+paclitaxel-based (gem-pac), others, or none.
RESULTS: The analysis identified 2,318 mPC patients: 1,589 (68.6%) with commercial insurance (COMI) and 729 (31.4%) with Medicare coverage. Overall, 75.8% of patients with COMI and 71.7% with Medicare had ≥1 inpatient visit; 44.7% and 44.9% of patients had ≥1 ER visit, respectively. Outpatient visits were 6.6 for patients with COMI and 6.1 for patients with Medicare; all-cause costs were $34,215 and $15,158, respectively. The most frequent first-line treatments were: COMI, FOLFIRINOX (42.5%), gem-pac (16.1%); Medicare, gem-pac (22.6%), FOLFIRINOX (17.3%). Overall, 25.7% of patients with COMI and 43.2% with Medicare did not receive treatment. Inpatient costs for patients with COMI and Medicare were, respectively: FOLFIRINOX, $12,566 and $5,489; gem-pac, $11,835 and $5,144; other, $13,610 and $6,154; none, $29,712 and $11,528. Outpatient costs for patients with COMI and Medicare were, respectively: FOLFIRINOX, $17,450 and $8,283; gem-pac, $19,864 and $8,132; other, $13,888 and $6,123; none, $10,496 and $4,165.
CONCLUSIONS: A high burden of both HRU and costs in patients with mPC were demonstrated. Average monthly inpatient costs were higher among patients who did not receive first-line treatment; outpatient costs were higher in patients who received treatment.
METHODS: Adult US patients with first mPC diagnosis (index date) between January 1, 2020-December 31, 2022 were identified in the Merative MarketScan database. Mean all-cause inpatient, outpatient, and emergency room [ER] visits and costs in USD for 1 year from index date were estimated as per-person-per-month (PPPM). First-line treatments started ≤90 days from index date were categorized as FOLFIRINOX-based, gemcitabine+paclitaxel-based (gem-pac), others, or none.
RESULTS: The analysis identified 2,318 mPC patients: 1,589 (68.6%) with commercial insurance (COMI) and 729 (31.4%) with Medicare coverage. Overall, 75.8% of patients with COMI and 71.7% with Medicare had ≥1 inpatient visit; 44.7% and 44.9% of patients had ≥1 ER visit, respectively. Outpatient visits were 6.6 for patients with COMI and 6.1 for patients with Medicare; all-cause costs were $34,215 and $15,158, respectively. The most frequent first-line treatments were: COMI, FOLFIRINOX (42.5%), gem-pac (16.1%); Medicare, gem-pac (22.6%), FOLFIRINOX (17.3%). Overall, 25.7% of patients with COMI and 43.2% with Medicare did not receive treatment. Inpatient costs for patients with COMI and Medicare were, respectively: FOLFIRINOX, $12,566 and $5,489; gem-pac, $11,835 and $5,144; other, $13,610 and $6,154; none, $29,712 and $11,528. Outpatient costs for patients with COMI and Medicare were, respectively: FOLFIRINOX, $17,450 and $8,283; gem-pac, $19,864 and $8,132; other, $13,888 and $6,123; none, $10,496 and $4,165.
CONCLUSIONS: A high burden of both HRU and costs in patients with mPC were demonstrated. Average monthly inpatient costs were higher among patients who did not receive first-line treatment; outpatient costs were higher in patients who received treatment.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE56
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology