OBJECTIVES: This retrospective claims data study compared the duration of therapy, as well as health care resource utilization (HCRU) and costs associated with first-line treatment of non-small cell lung cancer (NSCLC) patients with afatinib vs erlotinib in the United States (US).

METHODS: NSCLC patients aged ≥18 years initiating first-line treatment with afatinib or erlotinib from 2014-2017 were identified in a pooled dataset using three large US claims databases – Truven MarketScan, Optum Clinformatics Data Mart, and IQVIA PharMetrics Plus. Index date was defined as the first prescription fill date for either afatinib or erlotinib. Patients were required to have continuous enrolment for ≥6 months pre-index (baseline) and ≥30 days post-index, and were followed until the earlier of disenrollment or end of study period. Propensity score matching was used to adjust for baseline sociodemographic and clinical characteristics (age, sex, geographic region, Deyo-modified Charlson Comorbidity Index scores, and individual comorbidities), and Kaplan-Meier survival analysis was used to compare the median duration of therapy. All-cause HCRU and costs were assessed in the follow-up period and compared using t-tests and Chi-square tests.

RESULTS: There were 525 matched patients in each treatment cohort. Patients prescribed afatinib had significantly longer median treatment duration compared to those prescribed erlotinib (12.1 vs 9.9 months, p=0.0352). Significantly fewer afatinib patients experienced at least one inpatient (40.4% vs 52.2%, p=0.0001) or outpatient ER visit (45.7% vs 54.1%, p=0.0066), while the proportion of patients with at least one office visit (92.0% vs 91.6%, p=0.8219) or other outpatient visit (95.8% vs. 97.0%, p=0.3215) were comparable in both cohorts. Total costs per month were similar between the two cohorts ($14,972 vs $14,412; p=0.4415).

CONCLUSIONS: This study shows that NSCLC patients treated with afatinib have significantly longer first-line treatment duration while accruing similar total costs when compared to those treated with erlotinib.