EIGER: Cost Impact of Progression to Metastatic Disease Amongst US Patients With Gastric and Gastroesophageal Junction Cancer (GCGEJC)
Author(s)
Vishal Patel, MSc1, Linlin Luo, MSc2, Lei Li, MSc3, Heide A. Stirnadel-Farrant, PhD1.
1Oncology Outcomes Research, AstraZeneca, Cambridge, United Kingdom, 2Oncology Outcomes Research, AstraZeneca, Gaithersburg, MD, USA, 3GMA Payer Biometrics, AstraZeneca, Mississauga, ON, Canada.
1Oncology Outcomes Research, AstraZeneca, Cambridge, United Kingdom, 2Oncology Outcomes Research, AstraZeneca, Gaithersburg, MD, USA, 3GMA Payer Biometrics, AstraZeneca, Mississauga, ON, Canada.
OBJECTIVES: Economic costs and resource use are important components of the overall burden of disease for GC/GEJC patients. The objective of this study was to estimate the incremental cost associated with progression to metastatic disease in GC/GEJC patients.
METHODS: This retrospective, observational study used US insurance claims data from Optum Clinformatics®and included patients with non-metastatic GC/GEJC at diagnosis, with progression to metastatic disease reported between 01 Jan 2014 and 31 Dec 2022 (index date). Patients were divided into two cohorts based on insurance coverage: commercial or Medicare. Per patient per month (PPPM) costs were summarised by category (total, inpatient, outpatient, pharmacy). Monthly total healthcare-related costs were described pre- and post-index and input into a linear mixture model used to estimate the monthly incremental cost associated with progression to metastatic disease. PPPM costs were also summarised for patients who underwent surgery.
RESULTS: Among patients with progression to metastatic disease, commercially insured patients (n=225) incurred median (interquartile range [IQR]) total PPPM costs of $3569 (1744-6134) and $10,476 (3350-27,146) pre- and post-index, respectively, whilst Medicare insured patients (n=531) incurred total PPPM costs of $3323 (1484-6255) and $16,589 (6293-33,605), respectively. The mean (standard error) monthly incremental cost following progression to metastatic disease was $12,785 (2376) for commercially insured patients and $7522 (1830) for Medicare insured patients. In the subgroup that underwent surgery, median (IQR) PPPM costs pre- and post-index for commercially insured patients (n=73) were $4901 (3151-7443) and $11,743 (3601-28,636), respectively; and in Medicare insured patients (n=139) were $3816 (1696-6945) and $12,819 (5766-26,667), respectively.
CONCLUSIONS: Costs associated with GC/GEJC are a considerable burden to patients and payers. In particular, the costs following progression to metastatic disease are much higher than pre-index costs. Delayed progression could provide a cost benefit to patients and payers.
METHODS: This retrospective, observational study used US insurance claims data from Optum Clinformatics®and included patients with non-metastatic GC/GEJC at diagnosis, with progression to metastatic disease reported between 01 Jan 2014 and 31 Dec 2022 (index date). Patients were divided into two cohorts based on insurance coverage: commercial or Medicare. Per patient per month (PPPM) costs were summarised by category (total, inpatient, outpatient, pharmacy). Monthly total healthcare-related costs were described pre- and post-index and input into a linear mixture model used to estimate the monthly incremental cost associated with progression to metastatic disease. PPPM costs were also summarised for patients who underwent surgery.
RESULTS: Among patients with progression to metastatic disease, commercially insured patients (n=225) incurred median (interquartile range [IQR]) total PPPM costs of $3569 (1744-6134) and $10,476 (3350-27,146) pre- and post-index, respectively, whilst Medicare insured patients (n=531) incurred total PPPM costs of $3323 (1484-6255) and $16,589 (6293-33,605), respectively. The mean (standard error) monthly incremental cost following progression to metastatic disease was $12,785 (2376) for commercially insured patients and $7522 (1830) for Medicare insured patients. In the subgroup that underwent surgery, median (IQR) PPPM costs pre- and post-index for commercially insured patients (n=73) were $4901 (3151-7443) and $11,743 (3601-28,636), respectively; and in Medicare insured patients (n=139) were $3816 (1696-6945) and $12,819 (5766-26,667), respectively.
CONCLUSIONS: Costs associated with GC/GEJC are a considerable burden to patients and payers. In particular, the costs following progression to metastatic disease are much higher than pre-index costs. Delayed progression could provide a cost benefit to patients and payers.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE407
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Gastrointestinal Disorders, Oncology