Real-World Treatment Patterns, Healthcare Costs and Resource Utilization in First-Line Treatment of Metastatic NSCLC in the US using MarketScan® data
Author(s)
Divyan Chopra, PhD1, David M. Waterhouse, MD, MPH2, Ihtisham Sultan, PhD3, Alexander Lonshteyn, PhD4, Thomas E. Delea, MSIA4, Björn Stollenwerk, PhD5.
1HEOR, Amgen, Thousand Oaks, CA, USA, 2OHC (Oncology Hematology Care), Cincinnati, OH, USA, 3Amgen, Thousand Oaks, CA, USA, 4Avalere Health, Washington DC, DC, USA, 5Amgen (EUROPE) GmbH, Rotkreuz, Switzerland.
1HEOR, Amgen, Thousand Oaks, CA, USA, 2OHC (Oncology Hematology Care), Cincinnati, OH, USA, 3Amgen, Thousand Oaks, CA, USA, 4Avalere Health, Washington DC, DC, USA, 5Amgen (EUROPE) GmbH, Rotkreuz, Switzerland.
OBJECTIVES: Few studies have examined the current real-world landscape of first-line (1L) treatment for metastatic non-small cell lung cancer (NSCLC). This study aimed to evaluate real-world treatment patterns, healthcare costs, and healthcare resource utilization (HCRU) associated with non-targeted 1L treatment of metastatic NSCLC in the US.
METHODS: This descriptive retrospective study utilized data from the US MarketScan® claims database. Adult patients (18 years or older) initiating non-targeted 1L treatment for metastatic NSCLC between January 01, 2020 and March 31, 2023 were eligible. Continuous enrollment in medical and pharmacy benefits for minimum 6 months before NSCLC diagnosis until at least 30 days after starting 1L therapy was required.
RESULTS: 5,929 patients with metastatic NSCLC met the inclusion criteria. The median age at start of treatment was 64 years (Interquartile range: 59-74 years) and 49% were female; 52% were commercially insured. The mean National Cancer Index adapted Charlson Comorbidity Score was 1.4 (standard deviation [SD]: 1.5). The mean 1L treatment duration was 4.6 months (SD: 5.3), over an average follow-up of 10.7 months. Common 1L treatments regimens were immunotherapy (IO) plus platinum-based chemotherapy (PBCT) (41.9%), PBCT (25.3%), and IO alone (22.3%).Total 1L healthcare costs (mean) were $30,651 (SD: 26,260) per-patient per-month (PPPM), incurred mostly in outpatient settings ($24,598). Patients receiving IO + PBCT had the highest total costs ($35,609 PPPM) and outpatient costs ($29,508 PPPM) HCRU (mean) during 1L was mainly attributed to outpatient visits (7.1 [SD: 4.6] PPPM); highest for chemotherapy (PBCT: 10.6, non-PBCT: 6.6) followed IO + PBCT (6.4). Inpatient and emergency department accounted for an average of 0.21 (SD: 0.42) and 0.13 (SD: 0.32) visits PPPM.
CONCLUSIONS: Despite improvements in the NSCLC treatment landscape, non-targeted 1L treatments, particularly the widely utilized IO + chemotherapy is associated with substantial healthcare costs and utilization. This highlights an unmet need for advancing 1L treatments for NSCLC.
METHODS: This descriptive retrospective study utilized data from the US MarketScan® claims database. Adult patients (18 years or older) initiating non-targeted 1L treatment for metastatic NSCLC between January 01, 2020 and March 31, 2023 were eligible. Continuous enrollment in medical and pharmacy benefits for minimum 6 months before NSCLC diagnosis until at least 30 days after starting 1L therapy was required.
RESULTS: 5,929 patients with metastatic NSCLC met the inclusion criteria. The median age at start of treatment was 64 years (Interquartile range: 59-74 years) and 49% were female; 52% were commercially insured. The mean National Cancer Index adapted Charlson Comorbidity Score was 1.4 (standard deviation [SD]: 1.5). The mean 1L treatment duration was 4.6 months (SD: 5.3), over an average follow-up of 10.7 months. Common 1L treatments regimens were immunotherapy (IO) plus platinum-based chemotherapy (PBCT) (41.9%), PBCT (25.3%), and IO alone (22.3%).Total 1L healthcare costs (mean) were $30,651 (SD: 26,260) per-patient per-month (PPPM), incurred mostly in outpatient settings ($24,598). Patients receiving IO + PBCT had the highest total costs ($35,609 PPPM) and outpatient costs ($29,508 PPPM) HCRU (mean) during 1L was mainly attributed to outpatient visits (7.1 [SD: 4.6] PPPM); highest for chemotherapy (PBCT: 10.6, non-PBCT: 6.6) followed IO + PBCT (6.4). Inpatient and emergency department accounted for an average of 0.21 (SD: 0.42) and 0.13 (SD: 0.32) visits PPPM.
CONCLUSIONS: Despite improvements in the NSCLC treatment landscape, non-targeted 1L treatments, particularly the widely utilized IO + chemotherapy is associated with substantial healthcare costs and utilization. This highlights an unmet need for advancing 1L treatments for NSCLC.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE237
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology