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
Moderator
Soo Jin Seung, Toronto, Canada
Speakers
Shalak Gunjal, AstraZeneca, Mississauga, ON, Canada; Frances Simbulan, AZ, Mississauga, ON, Canada; Jimmy Tieu; Sharon Wang; Anisia Wong; Kealey Nguyen; Dominick Bossé
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