Healthcare Resource Utilization in Patients With Non-Small Cell Lung Cancer (NSCLC) and Epidermal Growth Factor Receptor Mutation (eGFRm): A Retrospective Cohort Study in a Portuguese Comprehensive Cancer Center
Author(s)
Ana Rodrigues, MD1, Marta Pina, MD1, Rita Calisto, MSc2, Maria José Bento, MD3, Pedro Leite-Silva, MSc3, Pedro Medeiros, MSc2, João Ramalho Carvalho, PhD4, Susana Ferreira Santos, PharmD4, José Mariano, PharmD4, Catarina Silva, MSc5, Ana Sofia Silva, MSc6, Patrícia Redondo, MSc6.
1Medical Oncology Department, IPO Porto, Porto, Portugal, 2Outcomes Research Lab, IPO Porto|Group of Epidemiology, Results, Economy and Management in Oncology – GEREMO – Research Center|Porto Comprehensive Cancer Center (Porto.CCC) & RISE@CI-IPOP (Health Research Network), Porto, Portugal, 3Epidemiology Department, IPO Porto|Group of Epidemiology, Results, Economy and Management in Oncology – GEREMO – Research Center|Porto Comprehensive Cancer Center (Porto.CCC) & RISE@CI-IPOP (Health Research Network), Porto, Portugal, 4Johnson & Johnson Innovative Medicine, Porto Salvo, Portugal, 5HE&OR, ISBE, Lisboa, Portugal, 6Group of Epidemiology, Results, Economy and Management in Oncology – GEREMO – Research Center|Porto Comprehensive Cancer Center (Porto.CCC) & RISE@CI-IPOP (Health Research Network), Porto, Portugal.
1Medical Oncology Department, IPO Porto, Porto, Portugal, 2Outcomes Research Lab, IPO Porto|Group of Epidemiology, Results, Economy and Management in Oncology – GEREMO – Research Center|Porto Comprehensive Cancer Center (Porto.CCC) & RISE@CI-IPOP (Health Research Network), Porto, Portugal, 3Epidemiology Department, IPO Porto|Group of Epidemiology, Results, Economy and Management in Oncology – GEREMO – Research Center|Porto Comprehensive Cancer Center (Porto.CCC) & RISE@CI-IPOP (Health Research Network), Porto, Portugal, 4Johnson & Johnson Innovative Medicine, Porto Salvo, Portugal, 5HE&OR, ISBE, Lisboa, Portugal, 6Group of Epidemiology, Results, Economy and Management in Oncology – GEREMO – Research Center|Porto Comprehensive Cancer Center (Porto.CCC) & RISE@CI-IPOP (Health Research Network), Porto, Portugal.
OBJECTIVES: Most patients with non-small cell lung cancer (NSCLC) are diagnosed at advanced or metastatic stage, with 15-50% harboring EGFR mutations (EGFRm). This study aimed to characterize healthcare resource utilization (HCRU) among this population in a real-world setting.
METHODS: Retrospective cohort study including adults with EGFRm advanced/metastatic NSCLC diagnosed between 2018-2021 and followed until last contact, death or end of study (Dec2023) at a Comprehensive Cancer Center. Data collected from medical/administrative records. HCRU included outpatient and emergency room (ER) visits, hospitalizations, complementary diagnostic and therapeutic procedures.
RESULTS: Overall, 110 patients were included. At diagnosis, median age 69.0 years, 76.4% female, 83.2% non-smokers, 97.3% adenocarcinoma, 93.6% stage IV, 33.6% ECOG PS 2-4, 40.9% had ≥3 metastatic sites, 10.0% had uncommon EGFR mutations. A minority of patients initiated best supportive care or curative-intent treatment, while 81.8% received palliative systemic therapy. During follow-up (median 18.9 months), 78.2% of patients had ER admissions (average, 4.0) and 76.4% were hospitalized (average, 2.0) for an average of 10.3 days; 98.2% underwent medical oncology appointments (average, 16.4), 37.3% had multidisciplinary lung appointments (average, 1.2), 8.2% thoracic surgery appointments (average, 2.9), 55% radio-oncology appointments (average, 4.1) and 85.5% had other specialist appointments (average, 9.7). All patients attended non-medical appointments (average, 10.5). Bone scintigraphy was performed in 50.9% of patients (average, 2.8), CT-scan in 94.5% (average, 20.1), MRI in 58.2% (average, 7.1), and PET in 71.8% (average, 1.2). By the end of study, 22.7% were still alive.
CONCLUSIONS: The treatment of EGFRm advanced/metastatic NSCLC requires a significant HCRU, resulting in potentially high budget impact for hospitals. These findings underscore the urgent need for more effective and cost-efficient treatments that not only improve patient outcomes but also reduce the economic impact associated with the care of these patients, promoting a more sustainable, patient-centered management.
METHODS: Retrospective cohort study including adults with EGFRm advanced/metastatic NSCLC diagnosed between 2018-2021 and followed until last contact, death or end of study (Dec2023) at a Comprehensive Cancer Center. Data collected from medical/administrative records. HCRU included outpatient and emergency room (ER) visits, hospitalizations, complementary diagnostic and therapeutic procedures.
RESULTS: Overall, 110 patients were included. At diagnosis, median age 69.0 years, 76.4% female, 83.2% non-smokers, 97.3% adenocarcinoma, 93.6% stage IV, 33.6% ECOG PS 2-4, 40.9% had ≥3 metastatic sites, 10.0% had uncommon EGFR mutations. A minority of patients initiated best supportive care or curative-intent treatment, while 81.8% received palliative systemic therapy. During follow-up (median 18.9 months), 78.2% of patients had ER admissions (average, 4.0) and 76.4% were hospitalized (average, 2.0) for an average of 10.3 days; 98.2% underwent medical oncology appointments (average, 16.4), 37.3% had multidisciplinary lung appointments (average, 1.2), 8.2% thoracic surgery appointments (average, 2.9), 55% radio-oncology appointments (average, 4.1) and 85.5% had other specialist appointments (average, 9.7). All patients attended non-medical appointments (average, 10.5). Bone scintigraphy was performed in 50.9% of patients (average, 2.8), CT-scan in 94.5% (average, 20.1), MRI in 58.2% (average, 7.1), and PET in 71.8% (average, 1.2). By the end of study, 22.7% were still alive.
CONCLUSIONS: The treatment of EGFRm advanced/metastatic NSCLC requires a significant HCRU, resulting in potentially high budget impact for hospitals. These findings underscore the urgent need for more effective and cost-efficient treatments that not only improve patient outcomes but also reduce the economic impact associated with the care of these patients, promoting a more sustainable, patient-centered management.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE518
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Real World Data & Information Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology