Healthcare Cost and Resource Utilization among First Line (1L) Treated Patients with Metastatic Non-small Cell Lung Cancer (mNSCLC): Analysis of SEER-Medicare Linked Claims in the US
Author(s)
Riddhi Babel, PhD1, Elizabeth Wehler, MPH1, Safiuddin Shoeb Syed, PharmD, MS2, Fatema Turkistani, PhD2, Kitty Rajagopalan, PhD2, Diana Chirovsky, PhD1;
1Merck & Co., Inc., Rahway, NJ, USA, 2Anlitiks Inc, Windermere, FL, USA
1Merck & Co., Inc., Rahway, NJ, USA, 2Anlitiks Inc, Windermere, FL, USA
Presentation Documents
OBJECTIVES: To examine health care resource utilization (HCRU) and costs among metastatic non-small cell lung cancer (mNSCLC) patients on first line (1L) treatment overall & by histology.
METHODS: SEER-Medicare database from 2007-2020 was used to examine claims of patients (aged ≥66 years) diagnosed with squamous (SQ) or non-squamous (NSQ), mNSCLC between 2007 and 2019 who initiated 1L therapy (chemotherapy, IO mono/combo, platinum/non-platinum) and had ≥12 months post-index follow up. Per patient per month (PPPM) all-cause, NSCLC-related, adverse event (AE)-related, and other-cause HCRU and costs were estimated by service-type (i.e., inpatient admission, outpatient, emergency, and skilled-nursing). Yearly disease management (DM) PPPM costs by progression status and mean terminal-care costs (i.e., 30 days before death) were also reported.
RESULTS: Mean age was 75.5 years, with 49% male, and 84.5% white in the overall cohort (n=1,578). SQ (n=311) and NSQ (n=1,267) cohorts had similar demographics, except SQ had a higher proportion of males (60.7%). The overall all-cause PPPM HCRU was 2.03 for outpatient visits, 0.26 for emergency visits, 0.18 for inpatient admissions, and 0.03 for skilled nursing, consisting of NSCLC-related (0.86, 0.04, 0.04, 0.01), AE-related (0.13, 0.08, 0.06, 0.01) and other-cause (1.04, 0.13, 0.08, 0.01), respectively. HCRU patterns were similar for SQ and NSQ. PPPM medical costs were similar across the cohorts (all-cause $9,857-$10,686, NSCLC-related $2,676-$2,954, AE-related $1,353-$1,517, other-cause $5,664-$6,378) as were mean terminal-care costs ($17,923-$18,982). In year 1, DM PPPM costs varied from $2,156 to $2,499 for progressed patients and from $2,263 to $3,150 for progression free, with PPPM costs decreasing over time.
CONCLUSIONS: Across cohorts, all-cause, NSCLC-related, and other-cause costs were mainly driven by outpatient visits, while AE-related costs were driven by inpatient admissions. Regardless of progression status, year 1 DM costs were highest for all patients, reflecting greater disease management intensity.
METHODS: SEER-Medicare database from 2007-2020 was used to examine claims of patients (aged ≥66 years) diagnosed with squamous (SQ) or non-squamous (NSQ), mNSCLC between 2007 and 2019 who initiated 1L therapy (chemotherapy, IO mono/combo, platinum/non-platinum) and had ≥12 months post-index follow up. Per patient per month (PPPM) all-cause, NSCLC-related, adverse event (AE)-related, and other-cause HCRU and costs were estimated by service-type (i.e., inpatient admission, outpatient, emergency, and skilled-nursing). Yearly disease management (DM) PPPM costs by progression status and mean terminal-care costs (i.e., 30 days before death) were also reported.
RESULTS: Mean age was 75.5 years, with 49% male, and 84.5% white in the overall cohort (n=1,578). SQ (n=311) and NSQ (n=1,267) cohorts had similar demographics, except SQ had a higher proportion of males (60.7%). The overall all-cause PPPM HCRU was 2.03 for outpatient visits, 0.26 for emergency visits, 0.18 for inpatient admissions, and 0.03 for skilled nursing, consisting of NSCLC-related (0.86, 0.04, 0.04, 0.01), AE-related (0.13, 0.08, 0.06, 0.01) and other-cause (1.04, 0.13, 0.08, 0.01), respectively. HCRU patterns were similar for SQ and NSQ. PPPM medical costs were similar across the cohorts (all-cause $9,857-$10,686, NSCLC-related $2,676-$2,954, AE-related $1,353-$1,517, other-cause $5,664-$6,378) as were mean terminal-care costs ($17,923-$18,982). In year 1, DM PPPM costs varied from $2,156 to $2,499 for progressed patients and from $2,263 to $3,150 for progression free, with PPPM costs decreasing over time.
CONCLUSIONS: Across cohorts, all-cause, NSCLC-related, and other-cause costs were mainly driven by outpatient visits, while AE-related costs were driven by inpatient admissions. Regardless of progression status, year 1 DM costs were highest for all patients, reflecting greater disease management intensity.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD95
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology