Healthcare Resource Utilization And Costs Following Disease Progression With First-Line Systemic Therapy In Patients With Advanced Endometrial Cancer in the US
Author(s)
Laura C. Moore-Schiltz, PhD1, Solomon J. Lubinga, MSc, PhD2, Joseph Tkacz, MS1;
1Inovalon Insights, Bowie, MD, USA, 2GSK, Collegeville, PA, USA
1Inovalon Insights, Bowie, MD, USA, 2GSK, Collegeville, PA, USA
Presentation Documents
OBJECTIVES: To estimate healthcare resource utilization (HCRU) and direct medical costs among patients with advanced endometrial cancer (EC) who initiated a first line of treatment (LOT) and reached at least a second LOT, and to estimate the association of treatment-free interval (TFI; duration from first LOT termination to initiation of second LOT) with HCRU and costs.
METHODS: The 100% Medicare Fee-for-Service database and MORE2 Registry of closed claims were used. Adults with an EC diagnosis between Jan-1-2016 and Jun-30-2021, with continuous enrollment benefits for ≥12 months before and ≥30 days following the second-line therapy start date were included. Patients were assigned to TFI cohorts of <6 or ≥6 months. Descriptive analyses of all-cause and EC-specific HCRU per patient per month (PPPM) are presented. Generalized linear models were estimated to assess the association between TFI and costs, adjusting for patient characteristics.
RESULTS: Of 2484 patients included in the study, 2102 (85%) had a TFI of <6 months. Among all patients, all-cause and EC-specific HCRU rates were 92.1% and 78.7% (physician office visits), 48.9% and 19.8% (emergency room visits), and 42.0% and 17.4% (hospitalization), respectively. Mean total all-cause healthcare costs PPPM were $9843 and were numerically higher among patients with a shorter TFI (<6-month TFI, $9881; ≥6-month TFI, $9638; cost ratio, 0.961; P=.4854). EC-specific costs were $5880 PPPM among all patients and were significantly higher among the shorter-TFI cohort (<6-month TFI, $5993; ≥6-month TFI, $5263; cost ratio, 0.747; P<.0001).
CONCLUSIONS: Patients with advanced EC who initiate subsequent treatment face considerable HCRU and costs. In this study, which focused on the time before immunotherapy became part of standard first-line treatment, most patients had a <6-month TFI, which is indicative of faster disease progression and was associated with numerically higher HCRU and significantly higher EC-specific costs. Effective up-front treatments could help alleviate this burden.
METHODS: The 100% Medicare Fee-for-Service database and MORE2 Registry of closed claims were used. Adults with an EC diagnosis between Jan-1-2016 and Jun-30-2021, with continuous enrollment benefits for ≥12 months before and ≥30 days following the second-line therapy start date were included. Patients were assigned to TFI cohorts of <6 or ≥6 months. Descriptive analyses of all-cause and EC-specific HCRU per patient per month (PPPM) are presented. Generalized linear models were estimated to assess the association between TFI and costs, adjusting for patient characteristics.
RESULTS: Of 2484 patients included in the study, 2102 (85%) had a TFI of <6 months. Among all patients, all-cause and EC-specific HCRU rates were 92.1% and 78.7% (physician office visits), 48.9% and 19.8% (emergency room visits), and 42.0% and 17.4% (hospitalization), respectively. Mean total all-cause healthcare costs PPPM were $9843 and were numerically higher among patients with a shorter TFI (<6-month TFI, $9881; ≥6-month TFI, $9638; cost ratio, 0.961; P=.4854). EC-specific costs were $5880 PPPM among all patients and were significantly higher among the shorter-TFI cohort (<6-month TFI, $5993; ≥6-month TFI, $5263; cost ratio, 0.747; P<.0001).
CONCLUSIONS: Patients with advanced EC who initiate subsequent treatment face considerable HCRU and costs. In this study, which focused on the time before immunotherapy became part of standard first-line treatment, most patients had a <6-month TFI, which is indicative of faster disease progression and was associated with numerically higher HCRU and significantly higher EC-specific costs. Effective up-front treatments could help alleviate this burden.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE408
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology