OBJECTIVES

Pancreatic ductal adenocarcinoma is the third leading cause of cancer-related death in the US. Hospitalizations related to neutropenia are a substantial economic burden among cancer patients. This analysis assessed inpatient costs and rates of neutropenia for mPC patients enrolled in US commercial health plans.

METHODS

Using the IQVIA PharMetrics Plus administrative claims database, data were obtained for adult patients with mPC treated between January 1, 2014 and May 31, 2019. Treatment regimens included were: FOLFIRI, FOLFOX, FOLFIRINOX, gemcitabine+nab-paclitaxel (gem+nab-P), and liposomal irinotecan-based treatment (lip-IRI). Patients were required to have continuous health coverage for ≥ 6 months prior to and ≥ 3 months after the first treatment date post-metastatic diagnosis. All-cause inpatient per patient costs (PPC) during treatment were calculated and adjusted to 2019 US dollars. The proportions of patients with neutropenia during treatment were assessed by treatment group.

RESULTS

2,731 mPC patients were identified (median age: 59y; IQR 54-64). Of these patients, 1,699 (62.2%) received second line treatment, 809 (29.6%) third line and 363 (13.2%) fourth line. Among patients treated in any line, 101 (3.7%) were treated with lip-IRI, 1,316 (48.2%) were treated with gem+nab-P, 612 (22.4%) with FOLRINOX, 281 (10.3%) with FOLFOX, and 208 (7.6%) with FOLFIRI. All-cause inpatient PPC were $8,220 for lip-IRI, $13,246 for gem+nab-P, $13,872 for FOLFIRINOX, $11,393 for FOLFOX, and $12,667 for FOLFIRI. Neutropenia was reported in 12% of patients receiving lip-IRI, 24% receiving gem-nab-p, 32% receiving FOLFIRINOX, and in 19% of patients receiving FOLFOX or FOLFIRI.

CONCLUSIONS

In this study mPC patients receiving lip-IRI experienced lower inpatient PPC and fewer neutropenia events during treatment than other common regimens. Further studies are needed to understand the impact of mPC treatment on neutropenia and inpatient admissions in the real-world.