REAL-WORLD ECONOMIC BURDEN OF DISEASE RECURRENCE AMONG US PATIENTS WITH CUTANEOUS SQUAMOUS CELL CARCINOMA (CSCC) WHO HAVE UNDERGONE LYMPHADENECTOMY AND ADJUVANT RADIATION THERAPY (RT)
Author(s)
Qian Xia, MS1, Chieh-I (JE) Chen, MPH1, Eilish McCann, PhD1, Shaohua Yu, MS2, Matthew G. Fury, MD, PhD1, Sarah Nia, PharmD1, James Harnett, MS, PharmD1, Ning Wu, PhD1, Chao Chen, PhD1, Priscila Goncalves, MD1.
1Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA, 2Humbi AI, Brentwood, TN, USA.
1Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA, 2Humbi AI, Brentwood, TN, USA.
OBJECTIVES: To assess healthcare resource utilization (HCRU) and costs in patients with CSCC during recurrence-free and post-recurrence periods after lymphadenectomy and adjuvant RT.
METHODS: Enrolled Medicare Fee-for-Service patients with CSCC (aged ≥65, ≥1 CSCC diagnosis) who underwent lymphadenectomy and adjuvant RT (≤60 days of lymphadenectomy) between 09/2019-03/2025 were followed from the end of RT until death or the end of enrollment/study period. Using a time-varying approach, each patient’s person-time and all-cause HCRU and costs (USD) were attributed to recurrence-free (from RT completion until first recurrence event [including death] or end of follow-up if no recurrence) and post-recurrence (from first recurrence until death or end of follow-up) periods. A sensitivity analysis reassigned HCRU/costs occurring ≤30 days before recurrence from recurrence-free to post-recurrence person-time to account for pre-diagnostic workup.
RESULTS: The study included 377 patients (median age 77 years; 86% male; 92% White) who contributed 6334 recurrence-free person-months; 196 patients experienced recurrence, contributing an additional 2685 post-recurrence person-months. Kaplan-Meier (KM)-estimated median time from RT completion to recurrence was 22.1 months (95% confidence interval [CI]: 16.1-28.9). KM-estimated median overall survival after recurrence was 20.6 months (95% CI: 8.7-35.0). Estimated mean annual all-cause inpatient, outpatient (non-emergency room), and physician-office visits increased from 0.4, 10.6, and 17.8 during the recurrence-free period to 0.8, 14.3, and 22.1 post-recurrence, respectively. Mean days in inpatient hospital, hospice care, and home health agency care increased from 3.3, 2.0, and 13.3 to 6.1, 11.8, and 24.1, respectively. Estimated mean annual all-cause costs were $26,880 during the recurrence-free period versus $68,352 post-recurrence. In the sensitivity analysis, mean annual costs were $24,504 during the recurrence-free period versus $68,904 post-recurrence.
CONCLUSIONS: Higher all-cause annual HCRU and ~2.5-fold higher annual costs were observed following recurrence versus prior to/no recurrence among patients with CSCC who underwent lymphadenectomy and adjuvant RT, driven by inpatient hospitalization and outpatient visits.
METHODS: Enrolled Medicare Fee-for-Service patients with CSCC (aged ≥65, ≥1 CSCC diagnosis) who underwent lymphadenectomy and adjuvant RT (≤60 days of lymphadenectomy) between 09/2019-03/2025 were followed from the end of RT until death or the end of enrollment/study period. Using a time-varying approach, each patient’s person-time and all-cause HCRU and costs (USD) were attributed to recurrence-free (from RT completion until first recurrence event [including death] or end of follow-up if no recurrence) and post-recurrence (from first recurrence until death or end of follow-up) periods. A sensitivity analysis reassigned HCRU/costs occurring ≤30 days before recurrence from recurrence-free to post-recurrence person-time to account for pre-diagnostic workup.
RESULTS: The study included 377 patients (median age 77 years; 86% male; 92% White) who contributed 6334 recurrence-free person-months; 196 patients experienced recurrence, contributing an additional 2685 post-recurrence person-months. Kaplan-Meier (KM)-estimated median time from RT completion to recurrence was 22.1 months (95% confidence interval [CI]: 16.1-28.9). KM-estimated median overall survival after recurrence was 20.6 months (95% CI: 8.7-35.0). Estimated mean annual all-cause inpatient, outpatient (non-emergency room), and physician-office visits increased from 0.4, 10.6, and 17.8 during the recurrence-free period to 0.8, 14.3, and 22.1 post-recurrence, respectively. Mean days in inpatient hospital, hospice care, and home health agency care increased from 3.3, 2.0, and 13.3 to 6.1, 11.8, and 24.1, respectively. Estimated mean annual all-cause costs were $26,880 during the recurrence-free period versus $68,352 post-recurrence. In the sensitivity analysis, mean annual costs were $24,504 during the recurrence-free period versus $68,904 post-recurrence.
CONCLUSIONS: Higher all-cause annual HCRU and ~2.5-fold higher annual costs were observed following recurrence versus prior to/no recurrence among patients with CSCC who underwent lymphadenectomy and adjuvant RT, driven by inpatient hospitalization and outpatient visits.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE395
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Genetic, Regenerative & Curative Therapies, Oncology, Surgery