Real-World Treatment Patterns, Patient Characteristics, Healthcare Resource Utilization and Costs for Intermediate Hepatocellular Carcinoma Patients in Canada: A Retrospective Cohort Study Using Provincial Administrative Data
Author(s)
Soo Jin Seung, BSc1, Shalak Gunjal, M.S.2, Frances Simbulan, MSc2, Jimmy Tieu, PharmD2, Sharon Wang, PhD2, Anisia Wong, MSc1, Kealey Nguyen, BSc1, Dominick Bossé, MD3;
1Sunnybrook Research Institute, HOPE Research Centre, Toronto, ON, Canada, 2AstraZeneca Canada, Mississauga, ON, Canada, 3University of Ottawa, Department of Medicine, Ottawa, ON, Canada
1Sunnybrook Research Institute, HOPE Research Centre, Toronto, ON, Canada, 2AstraZeneca Canada, Mississauga, ON, Canada, 3University of Ottawa, Department of Medicine, Ottawa, ON, Canada
Presentation Documents
OBJECTIVES: Intermediate hepatocellular carcinoma (iHCC) is a complex stage of liver cancer comprising of a heterogeneous patient population requiring individualized treatment strategies of locoregional and/or systemic therapies, contributing to significant economic burden. This study assessed patient characteristics, treatment patterns, healthcare resource utilization (HCRU) and costs among iHCC patients in the Canadian province of Ontario.
METHODS: A population-based retrospective cohort study of iHCC patients was conducted using linked administrative databases from April 1, 2010 to March 31, 2022. HCC patients were identified via ICD-10 (C22.0, C22.4, C22.8, C22.9) and ICD-O-3 (C22.0) codes and classified as intermediate-stage based on collaborative stage I-III who received any embolization, stereotactic body radiotherapy, or liver transplant at any point after diagnosis. The iHCC cohort was further stratified into three subgroups [1=locoregional therapy (LRT) only, 2=LRT followed by systemic therapy, 3=untreated] based on the treatment(s) received.
RESULTS: Of the 1,793 iHCC patients, the mean age at diagnosis was 66.2 ± 10.3 years, 79.4% were male, and mean study follow-up time was 2.4 ± 2.6 years. For subgroups 1 and 2, transarterial chemoembolization was the most frequently used first-line treatment. Sorafenib was the most frequently used systemic therapy following an LRT. The total iHCC-related healthcare expenditures in Ontario were approximately $200 million, with an average all-years overall cohort cost of $37,418 per patient-year. Inpatient hospitalizations and specialist billings were primary cost drivers amongst the three subgroups, ranging from $18,253-$37,432, and $7,966-$10,646 in the first year post-iHCC diagnosis, respectively. HCRU encounters per iHCC patient-year related to inpatient hospitalizations and specialist billings for subgroups 1,2 and 3 were 2.5, 2.2 and 2.0, and 34.1, 33.3 and 25.4, respectively.
CONCLUSIONS: Study findings show the high economic burden of iHCC in Ontario, highlighting the need for further research and investment on novel treatments to reduce healthcare burden.
METHODS: A population-based retrospective cohort study of iHCC patients was conducted using linked administrative databases from April 1, 2010 to March 31, 2022. HCC patients were identified via ICD-10 (C22.0, C22.4, C22.8, C22.9) and ICD-O-3 (C22.0) codes and classified as intermediate-stage based on collaborative stage I-III who received any embolization, stereotactic body radiotherapy, or liver transplant at any point after diagnosis. The iHCC cohort was further stratified into three subgroups [1=locoregional therapy (LRT) only, 2=LRT followed by systemic therapy, 3=untreated] based on the treatment(s) received.
RESULTS: Of the 1,793 iHCC patients, the mean age at diagnosis was 66.2 ± 10.3 years, 79.4% were male, and mean study follow-up time was 2.4 ± 2.6 years. For subgroups 1 and 2, transarterial chemoembolization was the most frequently used first-line treatment. Sorafenib was the most frequently used systemic therapy following an LRT. The total iHCC-related healthcare expenditures in Ontario were approximately $200 million, with an average all-years overall cohort cost of $37,418 per patient-year. Inpatient hospitalizations and specialist billings were primary cost drivers amongst the three subgroups, ranging from $18,253-$37,432, and $7,966-$10,646 in the first year post-iHCC diagnosis, respectively. HCRU encounters per iHCC patient-year related to inpatient hospitalizations and specialist billings for subgroups 1,2 and 3 were 2.5, 2.2 and 2.0, and 34.1, 33.3 and 25.4, respectively.
CONCLUSIONS: Study findings show the high economic burden of iHCC in Ontario, highlighting the need for further research and investment on novel treatments to reduce healthcare burden.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD65
Topic
Real World Data & Information Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology