OBJECTIVES

To characterize current treatment patterns and health care resource utilization (HRU) observed amongst patients with hepatocellular carcinoma (HCC) following the failure of sorafenib in real world setting in Taiwan.

METHODS

A chart review was conducted in 130 patients: ≥ 18 years old with HCC who received systemic therapy or best supportive care following failure of first line systemic treatment with sorafenib between 2016 and 2018. Anonymized data on patient characteristics, treatment pathways and survival was abstracted. Descriptive statistics were used to assess the outcomes.

RESULTS

Among the 130 patients, the mean (range) age was 61.7 (27 to 84) years; 103 (79.2%) were male; 81 (62.3%) had elevated alpha-fetoprotein (AFP≥400ng/mL); and 78.0% were deceased at the time of data abstraction. Post-sorafenib, 60 (46.2%) patients had systemic therapy, including nivolumab monotherapy (41.7%) and chemotherapy (25.0%). Oncologists, hepatologists, and gastroenterologist visits, at annual per patient rate of 7.4 (95% CI: 6.9, 8.1), 3.2 (95% CI: 2.8, 3.6), and 3.0 (95% CI: 2.6, 3.4); blood transfusions at rate of 4.8 (95% CI: 4.3, 5.3), and hospitalizations at rate of 2.2 (95% CI: 1.9, 2.6) were the key contributors to health resource utilization. Annual per patient hospitalisation rate was 2.5 (95% CI: 2.1, 3.0) in the elevated AFP group compared to 1.7 (95% CI: 1.3, 2.3) in the normal AFP group. Median survival from discontinuation of sorafenib was 6.9 months (95% CI: 5.9 – 9.0).

CONCLUSIONS :

This real-world evidence research on treatment patterns reflected high health resource utilization consistent with the severity of HCC, particularly in the elevated AFP group. Findings highlighted continuing high mortality in HCC, underlying a need for new treatments that can lengthen survival. Results can inform future evaluations of new HCC treatments that estimate the health economic impact of their adoption in Taiwan.