Treatment Patterns, Clinical Outcomes, Healthcare Resource Utilization, and Healthcare Costs Among Patients With Metastatic Gastric/Gastroesophageal Junction Cancer in Medicare Beneficiaries
Author(s)
Ziyan Chen, PhD1, Wei Song, PhD2, Hongbo Yang, BA, MA, PhD2, Adina Zhang, MS2, Grace Chen, MS2, Istvan MAJER, PhD3.
1Amgen Inc., Tampa, FL, USA, 2Analysis Group Inc., Boston, MA, USA, 3Amgen (Enrope) GmbH, Rotkreuz, Switzerland.
1Amgen Inc., Tampa, FL, USA, 2Analysis Group Inc., Boston, MA, USA, 3Amgen (Enrope) GmbH, Rotkreuz, Switzerland.
Presentation Documents
OBJECTIVES: This study describes real-world patient characteristics, treatment patterns, overall survival (OS), healthcare resource utilization (HCRU), and costs among Medicare beneficiaries with metastatic gastric and gastroesophageal junction cancer (G/GEJC) during the first-line (1L) therapy.
METHODS: A retrospective observational cohort study was conducted using 100% Medicare Fee-for-Service database. Patients (age ≥65 years) diagnosed with metastatic G/GEJC and initiating 1L non-HER2-targeted systemic anticancer therapy between 16 April 2021 and 29 February 2024, continuously enrolled for at least 6 months before and 1 month after the initiation of the 1L therapy (index date) were identified. Outcomes were assessed during the follow-up period between the index date and the date of death, end of continuous enrollment, or study end date (31 March 2024), whichever occurred first. All analyses were descriptive.
RESULTS: Among the 2,029 included patients, the mean age was 74.9 years, 72% were male and 80% were non-Hispanic White. The most frequent comorbidities were diabetes (26%) and chronic obstructive pulmonary disease (18%). The mean time from the first metastatic G/GEJC diagnosis to the initiation of 1L therapy was 0.6 months. The mean duration of 1L treatment was 4.6 months. The 3 most frequently used regimens were nivolumab plus FOLFOX (28.1%), FOLFOX (26.9%), and carboplatin plus paclitaxel (15.2%). The use of immunotherapy (i.e., nivolumab or pembrolizumab) was 44.6%. The median OS for the entire analysis cohort was 10.8 months. Outpatient visits represented the majority of HCRU (3.7 visits per patient per month [PPPM]). The mean all-cause healthcare cost was $17,152 PPPM, with outpatient costs, accounting for more than half of the total costs ($10,917 PPPM).
CONCLUSIONS: Our study describes recent treatment patterns in elderly patients and highlights the economic burden of the disease. Despite the approval and increased use of novel immunotherapies, patients with metastatic G/GEJC have poor prognosis, suggesting significant remaining unmet need.
METHODS: A retrospective observational cohort study was conducted using 100% Medicare Fee-for-Service database. Patients (age ≥65 years) diagnosed with metastatic G/GEJC and initiating 1L non-HER2-targeted systemic anticancer therapy between 16 April 2021 and 29 February 2024, continuously enrolled for at least 6 months before and 1 month after the initiation of the 1L therapy (index date) were identified. Outcomes were assessed during the follow-up period between the index date and the date of death, end of continuous enrollment, or study end date (31 March 2024), whichever occurred first. All analyses were descriptive.
RESULTS: Among the 2,029 included patients, the mean age was 74.9 years, 72% were male and 80% were non-Hispanic White. The most frequent comorbidities were diabetes (26%) and chronic obstructive pulmonary disease (18%). The mean time from the first metastatic G/GEJC diagnosis to the initiation of 1L therapy was 0.6 months. The mean duration of 1L treatment was 4.6 months. The 3 most frequently used regimens were nivolumab plus FOLFOX (28.1%), FOLFOX (26.9%), and carboplatin plus paclitaxel (15.2%). The use of immunotherapy (i.e., nivolumab or pembrolizumab) was 44.6%. The median OS for the entire analysis cohort was 10.8 months. Outpatient visits represented the majority of HCRU (3.7 visits per patient per month [PPPM]). The mean all-cause healthcare cost was $17,152 PPPM, with outpatient costs, accounting for more than half of the total costs ($10,917 PPPM).
CONCLUSIONS: Our study describes recent treatment patterns in elderly patients and highlights the economic burden of the disease. Despite the approval and increased use of novel immunotherapies, patients with metastatic G/GEJC have poor prognosis, suggesting significant remaining unmet need.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE423
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology