Real-World Hospital Stays Description and Cost Analysis of Immune Checkpoint Inhibitors (ICIs) Using National PMSI Data in France
Author(s)
Nicolas Virely, MSc1, Charlène Tournier, MSc2, Claire Leboucher, MSc2, Sylvaine Barbier, MSc2, Marine Sivignon, PharmD2.
1Putnam, Paris, France, 2Putnam, Lyon, France.
1Putnam, Paris, France, 2Putnam, Lyon, France.
OBJECTIVES: Immune checkpoint inhibitors (ICIs) are widely used across multiple cancer indications. As their hospital-based use increases, real-world data are essential to understand care patterns, diagnostic contexts, and economic implications at the population level. This study aimed to characterize hospital stays associated with 4 ICIs injections (pembrolizumab, nivolumab, durvalumab, and atezolizumab) in France using national hospital database (Programme de Médicalisation des Systèmes d’Information: PMSI), focusing on diagnosis-related groups (DRGs), principal diagnoses, care settings, and healthcare resource consumption, including cost and length of stay.
METHODS: A retrospective analysis of the PMSI database from 2021 to 2022 was conducted. Patients treated with ICIs were identified through hospital drug administration records. ICIs, care setting (ambulatory or inpatient), patients’ characteristics and stays were described, including an analysis of derived costs using national reimbursement tariffs.
RESULTS: A total of 99,226 patients and 856,104 stays were included. The study population had a mean age of 66.2±11.2 years, with 67% being male. Ambulatory care accounted for 96% of stays. The most frequent DRGs were chemotherapy sessions. Principal diagnoses involved lung cancers, melanoma, renal cancers and bladder cancers. Only 4.0% of stays were inpatient, with an average length of stay ranging from 5.8 to 13.9 days depending on the ICI. Most stays occurred in public hospitals (81.4%), and 95.6% of DRGs were classified as type Z, reflecting outpatient sessions without procedures. DRG severity was predominantly categorized as “other” (i.e no severity level), within inpatients stays, severity levels 1, 2, 3 and 4 accounted for 10.2%, 7.7%, 27.8% and 10.7%, respectively. Annual mean cost of stay by ICIs ranged from €4,287 to €6,755 in ambulatory care and from €8,140 to €12,316 in inpatient care.
CONCLUSIONS: This nationwide analysis provides a detailed description of real-world hospital utilization of ICI-care across hospital settings, supporting the importance of evaluating their organizational and environmental footprint.
METHODS: A retrospective analysis of the PMSI database from 2021 to 2022 was conducted. Patients treated with ICIs were identified through hospital drug administration records. ICIs, care setting (ambulatory or inpatient), patients’ characteristics and stays were described, including an analysis of derived costs using national reimbursement tariffs.
RESULTS: A total of 99,226 patients and 856,104 stays were included. The study population had a mean age of 66.2±11.2 years, with 67% being male. Ambulatory care accounted for 96% of stays. The most frequent DRGs were chemotherapy sessions. Principal diagnoses involved lung cancers, melanoma, renal cancers and bladder cancers. Only 4.0% of stays were inpatient, with an average length of stay ranging from 5.8 to 13.9 days depending on the ICI. Most stays occurred in public hospitals (81.4%), and 95.6% of DRGs were classified as type Z, reflecting outpatient sessions without procedures. DRG severity was predominantly categorized as “other” (i.e no severity level), within inpatients stays, severity levels 1, 2, 3 and 4 accounted for 10.2%, 7.7%, 27.8% and 10.7%, respectively. Annual mean cost of stay by ICIs ranged from €4,287 to €6,755 in ambulatory care and from €8,140 to €12,316 in inpatient care.
CONCLUSIONS: This nationwide analysis provides a detailed description of real-world hospital utilization of ICI-care across hospital settings, supporting the importance of evaluating their organizational and environmental footprint.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD95
Topic
Clinical Outcomes, Economic Evaluation, Health Service Delivery & Process of Care
Disease
Oncology