Healthcare Resource Utilization (HCRU), Costs, and Outcomes Among Patients With Extensive-Stage (ES) Small Cell Lung Cancer (SCLC) in the United States: A Retrospective, Real-World Analysis of Administrative Claims Data
Author(s)
Kamya Sankar, MD1, Marian Eberl, MD2, Sajid Ahmed, PharmD3, Hoa Le, MD, PhD3, Tara Herrmann, PhD, MBA3, Mei Tang, MD, PhD3, Sarah Park, MSc, PharmD3, Boris Gorsh, PharmD3, Joseph Tkacz, MS4, Virginia Noxon-Wood, PhD4, Sudhir Unni, PhD, MBA3.
1Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA, 2Daiichi Sankyo Europe GmbH, Munich, Germany, 3Daiichi Sankyo, Inc., Basking Ridge, NJ, USA, 4Inovalon Inc., Bowie, MD, USA.
1Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA, 2Daiichi Sankyo Europe GmbH, Munich, Germany, 3Daiichi Sankyo, Inc., Basking Ridge, NJ, USA, 4Inovalon Inc., Bowie, MD, USA.
Presentation Documents
OBJECTIVES: ES-SCLC is associated with considerable disease burden, and there is no globally established standard of care beyond first-line therapy. Administrative claims data were utilized to assess treatment patterns, HCRU, costs, and outcomes among patients with ES‑SCLC.
METHODS: This study used data from two nationally representative claims databases: 100% Medicare Fee-For-Service and the Inovalon MORE2 Registry®. Patients with lung cancer were included if they had a diagnosis of metastatic disease and initiated treatment indicative of ES‑SCLC (any first-, second-, or third-line regimen containing carboplatin/cisplatin plus etoposide/irinotecan, or lurbinectedin) between January 1, 2018 and December 31, 2022 (Medicare) or July 31, 2023 (MORE2). HCRU, costs, and treatment patterns were assessed during each line of therapy (LOT) among all patients; overall survival was assessed from initiation of each LOT among Medicare beneficiaries.
RESULTS: Overall, 2532 patients who received ≥1 LOT were included (mean age, 68.4 years; female, 53.8%; White, 73.7%), among whom 1049, 308, and 78 received a second, third, and fourth LOT, respectively. The most common therapies in each line were: regimens containing platinum-based chemotherapy plus topoisomerase inhibitor only (LOT1; received by 50.0% of patients); PD‑(L)1-inhibitor monotherapy (LOT2; 33.8%); topoisomerase-inhibitor monotherapy (LOT3; 20.5%); and chemotherapy other than platinum-based agents, topoisomerase inhibitors, and lurbinectedin (LOT4; 32.1%). Mean±standard deviation total costs per patient per month were $18,143±$13,989 (LOT1; SCLC-related, 74.7%), $21,446±$20,844 (LOT2; SCLC-related, 71.4%), $17,853±$20,111 (LOT3; SCLC-related, 72.7%), and $19,893±$35,849 (LOT4; SCLC‑related, 59.5%); “other outpatient costs” accounted for 55.6-59.2% of total costs. The main drivers of all-cause HCRU were physician’s office, pharmacy, and emergency-room visits. Median (95% CI) overall survival from treatment initiation was 9.8 months (9.1-10.3; LOT1), 6.1 months (5.7-6.7; LOT2), 4.0 months (3.2-5.3; LOT3), and 5.1 months (3.0-5.7; LOT4).
CONCLUSIONS: These results highlight the substantial financial burden and poor outcomes among patients with ES-SCLC throughout the treatment journey.
METHODS: This study used data from two nationally representative claims databases: 100% Medicare Fee-For-Service and the Inovalon MORE2 Registry®. Patients with lung cancer were included if they had a diagnosis of metastatic disease and initiated treatment indicative of ES‑SCLC (any first-, second-, or third-line regimen containing carboplatin/cisplatin plus etoposide/irinotecan, or lurbinectedin) between January 1, 2018 and December 31, 2022 (Medicare) or July 31, 2023 (MORE2). HCRU, costs, and treatment patterns were assessed during each line of therapy (LOT) among all patients; overall survival was assessed from initiation of each LOT among Medicare beneficiaries.
RESULTS: Overall, 2532 patients who received ≥1 LOT were included (mean age, 68.4 years; female, 53.8%; White, 73.7%), among whom 1049, 308, and 78 received a second, third, and fourth LOT, respectively. The most common therapies in each line were: regimens containing platinum-based chemotherapy plus topoisomerase inhibitor only (LOT1; received by 50.0% of patients); PD‑(L)1-inhibitor monotherapy (LOT2; 33.8%); topoisomerase-inhibitor monotherapy (LOT3; 20.5%); and chemotherapy other than platinum-based agents, topoisomerase inhibitors, and lurbinectedin (LOT4; 32.1%). Mean±standard deviation total costs per patient per month were $18,143±$13,989 (LOT1; SCLC-related, 74.7%), $21,446±$20,844 (LOT2; SCLC-related, 71.4%), $17,853±$20,111 (LOT3; SCLC-related, 72.7%), and $19,893±$35,849 (LOT4; SCLC‑related, 59.5%); “other outpatient costs” accounted for 55.6-59.2% of total costs. The main drivers of all-cause HCRU were physician’s office, pharmacy, and emergency-room visits. Median (95% CI) overall survival from treatment initiation was 9.8 months (9.1-10.3; LOT1), 6.1 months (5.7-6.7; LOT2), 4.0 months (3.2-5.3; LOT3), and 5.1 months (3.0-5.7; LOT4).
CONCLUSIONS: These results highlight the substantial financial burden and poor outcomes among patients with ES-SCLC throughout the treatment journey.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE369
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology