Health Care Resource Utilization (HCRU), and Direct Medical Costs Among Patients With Locally Advanced or Metastatic HER2 Negative Gastric Cancer (GC) in the United States.
Author(s)
Adriana Valderrama, MBA, PhD1, Ruth W. Dixon, PhD2, Hung-Yuan P. Chen, MPH2, Karthik Ramakrishnan, MPH1, Hiangkiat Tan, MS, B.Pharm2, Tracey Quimbo, MPH2, Sonal Bordia, MBBS1, Sofya Pintova, MD3;
1Merck & Co. Inc, Rahway, NJ, USA, 2Carelon Research, Wilmington, DE, USA, 3Icahn School of Medicine at Mount Sinai, New York, NY, USA
1Merck & Co. Inc, Rahway, NJ, USA, 2Carelon Research, Wilmington, DE, USA, 3Icahn School of Medicine at Mount Sinai, New York, NY, USA
Presentation Documents
OBJECTIVES: Recent advances in treatment of locally advanced or metastatic HER2 negative GC include the approval of 1L immunotherapies (IO). This study examined HCRU and costs in this population post-IO approval.
METHODS: This retrospective observational study utilized the Healthcare Integrated Research Database (HIRD®, administrative claims) and Anthem Cancer Care Quality Program (includes biomarker and cancer stage data) during the patient identification period from 5/1/2021 to 6/30/2023. Eligibility requirements were GC stage IIIB/IIIC/IV, initiated first-line (1L) chemo-/targeted-/immuno-therapy treatment (index date), ≥ 18 years old, continuous enrollment for ≥ 6 months pre-index, and ≥ 3 months post-index (except those who died within 3 months). HCRU and costs were assessed during pre-progression, post-progression (from 2L treatment initiation), and terminal care (the last 30 days before death) periods which were mutually exclusive.
RESULTS: A total of 107 patients were identified, with a mean follow-up of 9.0 (SD: 6.1) months. Median age was 61 years, 65% of patients were male, 73% were commercially insured, and 88% had ECOG score 0-1. 1L treatments included IO + chemotherapy (55%), IO monotherapy (5%), and non-IO therapies (40%). During the follow-up period, all (100%) patients had outpatient visits, 76% had ≥1 inpatient hospitalization, 42% had ≥1 emergency department (ED) visits, and 20% received hospice services. All-cause HCRU during the entire follow-up period totaled $33,560 (SD: $30,008) per patient per month, driven by outpatient costs, $19,579 (SD: 19,845); inpatient $11,228 (SD: 18,888); and physician office visits, $2,067 (SD: 5,100). All-cause total medical costs were $34,644 (SD: $56,218) pre-progression, $50,094 (SD: $63,239) post-progression, and $47,260 (SD: $73,901) during terminal periods.
CONCLUSIONS: Despite advances in therapeutic options, a significant unmet need remains for locally advanced/metastatic HER2 negative GC with only 55% of patients receiving 1L IO + chemotherapy. Optimizing 1L treatment is crucial to avoid high progression costs.
METHODS: This retrospective observational study utilized the Healthcare Integrated Research Database (HIRD®, administrative claims) and Anthem Cancer Care Quality Program (includes biomarker and cancer stage data) during the patient identification period from 5/1/2021 to 6/30/2023. Eligibility requirements were GC stage IIIB/IIIC/IV, initiated first-line (1L) chemo-/targeted-/immuno-therapy treatment (index date), ≥ 18 years old, continuous enrollment for ≥ 6 months pre-index, and ≥ 3 months post-index (except those who died within 3 months). HCRU and costs were assessed during pre-progression, post-progression (from 2L treatment initiation), and terminal care (the last 30 days before death) periods which were mutually exclusive.
RESULTS: A total of 107 patients were identified, with a mean follow-up of 9.0 (SD: 6.1) months. Median age was 61 years, 65% of patients were male, 73% were commercially insured, and 88% had ECOG score 0-1. 1L treatments included IO + chemotherapy (55%), IO monotherapy (5%), and non-IO therapies (40%). During the follow-up period, all (100%) patients had outpatient visits, 76% had ≥1 inpatient hospitalization, 42% had ≥1 emergency department (ED) visits, and 20% received hospice services. All-cause HCRU during the entire follow-up period totaled $33,560 (SD: $30,008) per patient per month, driven by outpatient costs, $19,579 (SD: 19,845); inpatient $11,228 (SD: 18,888); and physician office visits, $2,067 (SD: 5,100). All-cause total medical costs were $34,644 (SD: $56,218) pre-progression, $50,094 (SD: $63,239) post-progression, and $47,260 (SD: $73,901) during terminal periods.
CONCLUSIONS: Despite advances in therapeutic options, a significant unmet need remains for locally advanced/metastatic HER2 negative GC with only 55% of patients receiving 1L IO + chemotherapy. Optimizing 1L treatment is crucial to avoid high progression costs.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD71
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Oncology