Author(s)
Grumberg V1, Cotte FE2, Jouaneton B3, Jolivel R3, Corre R4, Giaj-Levra M5, Gaudin AF6, Calvet CY6, Assie JB7, Chouaid C8
1Master Market-Access and Economic Evaluation, Université Paris-Saclay, Chatenay-Malabry, France, 2Bristol-Myers Squibb, RUEIL MALMAISON, France, 3HEVA, Lyon, France, 4Centre Hospitalier Intercommunal de Quimper, Quimper, France, 5Centre Hospitalier Universitaire Grenoble Alpes (CHUGA), Grenoble, France, 6Bristol-Myers Squibb, Rueil-Malmaison, France, 7Centre de Recherches des Cordeliers, Université de Paris, INSERM, Paris, France, 8Department of Chest Medicine, Créteil University Hospital, Créteil, France
OBJECTIVES: In advanced non-small cell lung cancer (aNSCLC), healthcare resource utilization (HCRU) and costs usually increase until end of life. Few studies describe long-term HCRU and costs associated with aNSCLC patients treated with immunotherapy. The objective of this analysis was to describe 3-year HCRU and costs associated with previously treated aNSCLC patients who initiated nivolumab. METHODS: Based on the National hospitals database (PMSI), we constituted a retrospective cohort of all aNSCLC patients initiating nivolumab in 2015-2016 and followed until Dec 2018. HCRU, described for each year after nivolumab initiation, included hospital visits (i.e. one-day stays, emergency visits, consultations) and hospitalizations (i.e. intensive/reanimation care, palliative care, rehabilitation care, hospitalization at home, other hospitalizations). Trends in HCRU were analyzed with Mann-Kendall test. RESULTS: 10,452 patients initiated nivolumab during the inclusion period. The mean number of hospital visits per patient diminished over the follow-up (p<0.001): 21.1 in the first year (Y1; n=10,452), 19.6 in the second year (Y2; n=4636) and 13.1 the third year (Y3; n=2514). One-day stays represented the highest proportion of hospital visits (66% in Y1, 61% in Y2 and 57% in Y3). Regarding hospitalizations, the mean cumulative number of days per patient decreased from 27.6 in Y1 to 22.0 in Y2 and 13.5 in Y3 (p<0.001). During Y1, palliative care represented 31% of hospitalization days while it constituted 28% in Y2 and 23% in Y3. Hospital visits and hospitalization costs per patient decreased from 16,790€ in Y1 (hospital visits/days of hospitalization: 38%/62%) to 13,405€ in Y2 (41%/59%) and 8524€ in Y3 (41%/59%) (p<0.001). CONCLUSIONS: HCRU and costs associated with patients receiving nivolumab tended to decrease over the 3 years. This suggests that care needs and also intensity of care decrease over time for patients benefiting from immunotherapy. Further research on long-term survivors could explore the relationship between HCRU and quality-of-life.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PCN348
Topic
Economic Evaluation, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Drugs, Oncology
