Healthcare Resource Utilization and Economic Burden of Metastatic Pancreatic Cancer: A US Commercial and Medicare Claims Analysis From 2020 to 2023
Moderator
Rupali Fuldeore, MS, Astellas, Vernon Hills, IL, United States
Speakers
Kenneth H. Yu; Adaeze Q Amaefule, MS, PharmD; Gergana Georgieva; Tomomi Kimura; Baoguo Jiang
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