DISTINCT CARE PATHWAYS AND ECONOMIC IMPACT IN TREATED GEP-NET: A U.S. CLAIMS ANALYSIS OF METASTATIC VS NON-METASTATIC DISEASE
Author(s)
SHAILJA PANDEY, B.TECH.1, Geetanjan Singh Ahluwalia, B.TECH., PGPM2, Maxine Diehl, B.A3, Sri Saikumar, B.E., M.S., M.B.A3, Dushyant Katariya, B.TECH.2;
1Trinity Life Sciences, Bangalore, India, 2Trinity Life Sciences, Gurugram, India, 3Trinity Life Sciences, Waltham, MA, USA
1Trinity Life Sciences, Bangalore, India, 2Trinity Life Sciences, Gurugram, India, 3Trinity Life Sciences, Waltham, MA, USA
OBJECTIVES: Gastroenteropancreatic Neuroendocrine Tumors (GEP-NET) is a rare, heterogeneous malignancies with variable treatment approaches and disease trajectories. This study evaluated economic impact and care pathway differences among treated patients with metastatic and non‑metastatic GEP‑NET in the United States.
METHODS: A retrospective, descriptive claims analysis was conducted using Komodo Healthcare Map™ cost-of-care data between 1st January 2021 - 31st December 2024. Incident treated patients were included in the study at the first treatment date of any of the following treatments- chemotherapy, Somatostatin Analogs (SSA), Peptide Receptor Radionuclide Therapy (PRRT), immunotherapy and targeted therapy during the study period, with a requirement of 12 & 36-months continuous enrollment before and after index respectively. Annualized HCRU and cost analyses compared metastatic and non-metastatic cohorts over 36 months post-index. The analysis was based on claims with complete cost data.
RESULTS: We identified 1,161 treated patients with GEP-NET meeting study criteria: 76% were metastatic while 24% were non-metastatic patients. Annualized median all‑cause costs were higher for metastatic patients than non-metastatic ($100K vs $55K), with medical costs showing a similar pattern ($90K vs $42K). Inpatient ($10K vs $8K), outpatient ($3.3K vs $2.7K), and other service costs ($3.8K vs $3.7K) were likewise greater among metastatic patients, reflecting their elevated economic burden. Annualized all-cause medical visits (median:35.66 vs 34.67) were higher for metastatic patients while annualized all-cause pharmacy visits (median:25.66 vs 22) were higher for non-metastatic patients.
CONCLUSIONS: Beyond higher costs, metastatic GEP-NET is characterized by greater inpatient and outpatient utilization, whereas non-metastatic disease shows higher pharmacy engagement. These findings highlight clinically relevant differences in care pathways and complexity, underscoring the need for stage-specific management strategies and resource planning to optimize outcomes and support value-based care models.
METHODS: A retrospective, descriptive claims analysis was conducted using Komodo Healthcare Map™ cost-of-care data between 1st January 2021 - 31st December 2024. Incident treated patients were included in the study at the first treatment date of any of the following treatments- chemotherapy, Somatostatin Analogs (SSA), Peptide Receptor Radionuclide Therapy (PRRT), immunotherapy and targeted therapy during the study period, with a requirement of 12 & 36-months continuous enrollment before and after index respectively. Annualized HCRU and cost analyses compared metastatic and non-metastatic cohorts over 36 months post-index. The analysis was based on claims with complete cost data.
RESULTS: We identified 1,161 treated patients with GEP-NET meeting study criteria: 76% were metastatic while 24% were non-metastatic patients. Annualized median all‑cause costs were higher for metastatic patients than non-metastatic ($100K vs $55K), with medical costs showing a similar pattern ($90K vs $42K). Inpatient ($10K vs $8K), outpatient ($3.3K vs $2.7K), and other service costs ($3.8K vs $3.7K) were likewise greater among metastatic patients, reflecting their elevated economic burden. Annualized all-cause medical visits (median:35.66 vs 34.67) were higher for metastatic patients while annualized all-cause pharmacy visits (median:25.66 vs 22) were higher for non-metastatic patients.
CONCLUSIONS: Beyond higher costs, metastatic GEP-NET is characterized by greater inpatient and outpatient utilization, whereas non-metastatic disease shows higher pharmacy engagement. These findings highlight clinically relevant differences in care pathways and complexity, underscoring the need for stage-specific management strategies and resource planning to optimize outcomes and support value-based care models.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE375
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Gastrointestinal Disorders, SDC: Oncology