Molecular Profiling, Treatment (Tx) Patterns, and Healthcare Resource Utilization (HCRU) in United States Patients with Unresectable Locally Advanced/Metastatic Biliary Tract Cancer
Author(s)
Richard Kim, MD1, Xiaozhou Fan, PhD2, Chengbo Yuan, PhD2, Wayne Su, MSc2, Jennifer Shear, PharmD2, Weiyi Ni, PhD2, Qingshan Qian, PhD2, Minxuan Huang, PhD2, Joan Zape, PhD2, Mark Ozog, PhD, MBA3, Farshid Dayyani, MD4;
1Moffitt Cancer Center, Tampa, FL, USA, 2Jazz Pharmaceuticals, Philadelphia, PA, USA, 3Jazz Pharmaceuticals, Palo Alto, CA, USA, 4University of California Irvine Chao Family Comprehensive Cancer Center, Orange, CA, USA
1Moffitt Cancer Center, Tampa, FL, USA, 2Jazz Pharmaceuticals, Philadelphia, PA, USA, 3Jazz Pharmaceuticals, Palo Alto, CA, USA, 4University of California Irvine Chao Family Comprehensive Cancer Center, Orange, CA, USA
Presentation Documents
OBJECTIVES: Multiple genetic alterations, such as HER2, have emerged as targetable biomarkers in biliary tract cancer (BTC). Here, we describe the testing and tx patterns, HCRU, and costs among patients with advanced BTC, reflecting the recent evolution of the tx landscape.
METHODS: Optum Market Clarity, a linked database of electronic health records and administrative claims database, was used to identify patients with advanced BTC (2016-2023) indexed on their date of diagnosis; outcomes were further sub-grouped to 1) index date pre/post 01/2020 and 2) evidence of HER2 disease (IHC3+ and/or receiving HER2-targeted therapy).
RESULTS: 5,480 patients were identified (mean age: 67 [SD 11.7] years; 54% female; 53% with Medicare). The testing rate for any biomarker was 57% any time after the index. The proportions of patients receiving systemic tx in 1L, 2L, and 3L were 56%, 21%, and 7%, respectively. The proportion of any targeted therapy in 1L was 19% (driven by PD-L1 16%); it increased from 5% to 31% pre/post 2020. In 2L and 3L, any targeted therapy use was 26% and 45%, respectively. Percent PD-L1 use was similar to all other targeted therapies combined, regardless of lines and date. 61 patients had evidence of HER2 disease (1L n=55, 2L n=40, 3L n=26), of which, 44 received HER2-targeted tx in any line of therapy. The median total all-cause costs per-treated-patient-per-month of the overall cohort in 1L, 2L, and 3L were $18,888, $21,902, and $24,759, respectively. A similar finding of increasing all-cause costs with tx line progression and slightly higher median costs were observed in post 2020 and HER2 disease subgroups.
CONCLUSIONS: This real-world evidence study shows that biomarker testing and targeted therapies might be underutilized in patients with advanced BTC. All-cause healthcare costs increased with tx line and were slightly higher after 2020 and in the HER2 subgroup.
METHODS: Optum Market Clarity, a linked database of electronic health records and administrative claims database, was used to identify patients with advanced BTC (2016-2023) indexed on their date of diagnosis; outcomes were further sub-grouped to 1) index date pre/post 01/2020 and 2) evidence of HER2 disease (IHC3+ and/or receiving HER2-targeted therapy).
RESULTS: 5,480 patients were identified (mean age: 67 [SD 11.7] years; 54% female; 53% with Medicare). The testing rate for any biomarker was 57% any time after the index. The proportions of patients receiving systemic tx in 1L, 2L, and 3L were 56%, 21%, and 7%, respectively. The proportion of any targeted therapy in 1L was 19% (driven by PD-L1 16%); it increased from 5% to 31% pre/post 2020. In 2L and 3L, any targeted therapy use was 26% and 45%, respectively. Percent PD-L1 use was similar to all other targeted therapies combined, regardless of lines and date. 61 patients had evidence of HER2 disease (1L n=55, 2L n=40, 3L n=26), of which, 44 received HER2-targeted tx in any line of therapy. The median total all-cause costs per-treated-patient-per-month of the overall cohort in 1L, 2L, and 3L were $18,888, $21,902, and $24,759, respectively. A similar finding of increasing all-cause costs with tx line progression and slightly higher median costs were observed in post 2020 and HER2 disease subgroups.
CONCLUSIONS: This real-world evidence study shows that biomarker testing and targeted therapies might be underutilized in patients with advanced BTC. All-cause healthcare costs increased with tx line and were slightly higher after 2020 and in the HER2 subgroup.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE416
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology