Healthcare Resource Utilization (HCRU) and Associated Costs in Patients With Advanced Merkel Cell Carcinoma (aMCC) in Germany: Analysis From the MCC TRIM Registry Study
Author(s)
Hamid Mahmoudpour, PharmD, PhD1, Jürgen C. Becker, MD2, Dirk Schadendorf, MD3, Ulrike Leiter, MD4, Friedegund Meier, MD5, Rudolf Herbst, MD6, Stephan Grabbe, MD7, Peter Mohr, MD8, Claudia Pföhler, MD9, Christoffer Gerbhardt, MD10, Fabian Ziller, MD11, Lisa Zimmer, MD3, Emmanuelle Boutmy, PhD1, Sebastian Hoff, PhD1, Mairead Kearney, MB, BCh, MPH, MBA, MSC Econ12, Margarita Shlaen, MPH13, Selma Ugurel, MD14, Dina Oksen, MSc, MPH1.
1Merck Healthcare KGaA, Darmstadt, Germany, 2Departments of Translational Skin Cancer Research and Dermatology, University Hospital Essen, Essen, Germany, 3Department of Dermatology, University Hospital Essen, Essen, Germany, 4Department of Dermatology, Center for Dermatooncology, Eberhard Karls University of Tübingen, Tübingen, Germany, 5Department of Dermatology, Faculty of Medicine, University Hospital Carl Gustav Carus, Dresden, Germany, 6Department of Dermatology, Helios Klinikum Erfurt, Erfurt, Germany, 7Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany, 8Department of Dermatology, Elbe-Kliniken, Buxtehude, Germany, 9Department of Dermatology, Saarland University Medical School, Homburg/Saar, Germany, 10Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany, 11Department of Dermatology, DRK Krankenhaus Rabenstein, Chemnitz, Germany, 12Global Value Demonstration, Market Access and Pricing, Biopharma, Global Operations, Merck Healthcare KGaA, Darmstadt, Germany, 13IQVIA Commercial GmbH & Co. OHG, München, Germany, 14Department of Dermatology, University Hospital Essen, University of Duisburg-Essen & German Cancer Consortium Heidelberg, Heidelberg, Germany.
1Merck Healthcare KGaA, Darmstadt, Germany, 2Departments of Translational Skin Cancer Research and Dermatology, University Hospital Essen, Essen, Germany, 3Department of Dermatology, University Hospital Essen, Essen, Germany, 4Department of Dermatology, Center for Dermatooncology, Eberhard Karls University of Tübingen, Tübingen, Germany, 5Department of Dermatology, Faculty of Medicine, University Hospital Carl Gustav Carus, Dresden, Germany, 6Department of Dermatology, Helios Klinikum Erfurt, Erfurt, Germany, 7Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany, 8Department of Dermatology, Elbe-Kliniken, Buxtehude, Germany, 9Department of Dermatology, Saarland University Medical School, Homburg/Saar, Germany, 10Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany, 11Department of Dermatology, DRK Krankenhaus Rabenstein, Chemnitz, Germany, 12Global Value Demonstration, Market Access and Pricing, Biopharma, Global Operations, Merck Healthcare KGaA, Darmstadt, Germany, 13IQVIA Commercial GmbH & Co. OHG, München, Germany, 14Department of Dermatology, University Hospital Essen, University of Duisburg-Essen & German Cancer Consortium Heidelberg, Heidelberg, Germany.
OBJECTIVES: Limited real-world HCRU data are available for patients with MCC, a rare, aggressive skin cancer. This study aimed to quantify HCRU patterns and associated costs in patients with aMCC to inform healthcare planning and resource allocation.
METHODS: Data were analyzed from the MCC TRIM registry, a prospective, noninterventional, multicenter cohort study in Germany. Patients diagnosed with unresectable stage III or IV MCC were included in the advanced stage analysis set (ASAS). HCRU was assessed as units and associated direct medical costs per person per month (PPPM) to account for variable follow-up. Resources evaluated included outpatient visits, hospitalizations, emergency department visits, imaging procedures, laboratory tests, and therapeutic interventions.
RESULTS: The ASAS included 276 patients (114 stage III; 162 stage IV); 65.6% were male (95% CI, 60.0%-71.2%) and mean age at initial diagnosis was 74.9 years (SD, 10.0). In 186 patients not initially diagnosed with aMCC, median time between initial diagnosis and aMCC diagnosis was 314 days (IQR, 199-575). ECOG performance status in patients with available data (n=225) was 0 in 61.8%, 1 in 28.0%, and 2-4 in 10.2%. Median number of outpatient visits was 0.5 PPPM (IQR, 0.2-1.4), with associated median costs of €12 PPPM (IQR, €3-€37) and mean costs of €25 PPPM (SD, €33). Median number of hospitalizations was 0 PPPM (IQR, 0-0.1), with associated median costs of €103 PPPM (IQR, €0-€332). In deceased patients (n=108), mean total costs increased from €290.5 PPPM (SD, €793.2) >12 months prior to death to €3004.1 PPPM (SD, €5952.3) within the last 3 months before death.
CONCLUSIONS: This real-world study, conducted within a healthcare system offering universal coverage, provides important insights into HCRU patterns and associated costs in patients with aMCC. PPPM costs near the end of life were highly concentrated in the last few months prior to death and were primarily driven by inpatient care.
METHODS: Data were analyzed from the MCC TRIM registry, a prospective, noninterventional, multicenter cohort study in Germany. Patients diagnosed with unresectable stage III or IV MCC were included in the advanced stage analysis set (ASAS). HCRU was assessed as units and associated direct medical costs per person per month (PPPM) to account for variable follow-up. Resources evaluated included outpatient visits, hospitalizations, emergency department visits, imaging procedures, laboratory tests, and therapeutic interventions.
RESULTS: The ASAS included 276 patients (114 stage III; 162 stage IV); 65.6% were male (95% CI, 60.0%-71.2%) and mean age at initial diagnosis was 74.9 years (SD, 10.0). In 186 patients not initially diagnosed with aMCC, median time between initial diagnosis and aMCC diagnosis was 314 days (IQR, 199-575). ECOG performance status in patients with available data (n=225) was 0 in 61.8%, 1 in 28.0%, and 2-4 in 10.2%. Median number of outpatient visits was 0.5 PPPM (IQR, 0.2-1.4), with associated median costs of €12 PPPM (IQR, €3-€37) and mean costs of €25 PPPM (SD, €33). Median number of hospitalizations was 0 PPPM (IQR, 0-0.1), with associated median costs of €103 PPPM (IQR, €0-€332). In deceased patients (n=108), mean total costs increased from €290.5 PPPM (SD, €793.2) >12 months prior to death to €3004.1 PPPM (SD, €5952.3) within the last 3 months before death.
CONCLUSIONS: This real-world study, conducted within a healthcare system offering universal coverage, provides important insights into HCRU patterns and associated costs in patients with aMCC. PPPM costs near the end of life were highly concentrated in the last few months prior to death and were primarily driven by inpatient care.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE509
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology