OBJECTIVE: This retrospective study measured direct cost of care and patient out-of-pocket (OOP) spending for Medicare Fee-For-Service (FFS) beneficiaries with advanced melanoma (advMelanoma), advanced renal cell carcinoma (aRCC), or advanced non-small cell lung cancer (aNSCLC).

METHODS: The 100% sample of Medicare FFS enrollment/claims data was used to identify adult patients with ≥1 inpatient or ≥2 outpatient medical claims with diagnosis of melanoma (ICD-10-CM C43.X), RCC (C64.1, C64.2, C64.9), or lung cancer (C34.XX) and ≥2 claims with diagnosis of metastasis/secondary neoplasm (C77.x-C79.x) between July 1, 2017 and June 31, 2019. Date of first metastasis was considered the index date. Cohorts were defined by primary tumor type. Total all-cause direct cost of care (based on Medicare payments for all adjudicated claims for Parts A/B/D medical and pharmacy services) and patient OOP spending were measured over a 24-month period.

RESULTS: The study population included 3,429, 2,551, and 8,450 patients with advMelanoma, aRCC, and aNSCLC, respectively. Mean Parts A/B/D Medicare payments per patient over 24-months (and per-patient per-month [PPPM]) were $118,235 ($4,927) for patients with advMelanoma, $139,408 ($5,809) for patients with aRCC, and $145,775 ($6,074) for patients with aNSCLC. Mean OOP costs per patient over 24-months (PPPM) were $22,995 ($958), $21,261 ($886), and $27,636 ($1,152), respectively. This study does not include the cost of lost productivity or premature death from cancer.

CONCLUSION: In this retrospective study of 14,430 Medicare beneficiaries diagnosed with 1 of 3 advanced solid tumors who survived at least 24 months, there is considerable cost to the Medicare program and patients associated with the treatment of melanoma, RCC, and NSCLC. This study highlights the need for innovative strategies to help address patient burden while acknowledging the advances made in cancer detection and treatment, which have contributed to increased survival in this patient population.