Health Care Resource Utilization (HCRU) and Costs of First-Line Systemic Therapy (1LT) for Locally Advanced or Metastatic Non-Small Cell Lung Cancer (a/mNSCLC) - A Secondary Analysis of Claims Data from the United States (US)
Author(s)
Spira AI1, Knoll S2, Smith TW2, Scotchmer A3, Bauer M4
1Virginia Cancer Specialists Research Institute and NEXT Oncology, Fairfax, VA, USA, 2Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, 3Novartis Pharmaceuticals, London, UK, 4Novartis Pharma AG, Basel, BS, Switzerland
Presentation Documents
OBJECTIVES: To estimate HCRU, costs, and time to treatment discontinuation (TTD) during 1LT for a/mNSCLC, among commercially insured adults in the US eligible for treatment with 1LT for a/mNSCLC.
METHODS: This real-world, retrospective cohort study analyzed US claims data (Optum® Clinformatics® Data Mart) covering 01JAN2019-30JUN2021, using an adapted, validated case-finding algorithm for identifying patients receiving 1LT in administrative claims data. Monthly per-patient HCRU and associated costs during 1LT for a/mNSCLC were calculated using descriptive analyses, stratified by type of 1LT regimen. Kaplan-Meier analyses were used to estimate TTD of 1LT.
RESULTS: The analysis included 1,062 patients with a/mNSCLC receiving 1LT (48.7% women), with mean (standard deviation [SD]) age at 1LT initiation of 71.0 (8.0) years, and National Cancer Institute Comorbidity Index score of 1.1 (0. 7). Mean (SD) monthly per-patient HCRU included outpatient (10.3 [8.6]), emergency room (0.2 [0.5]), and inpatient (0.1 [0.3]) visits. Mean (SD) monthly per-patient total costs were US$ 36,744 (24,531); of these, US$ 33,703 (22,818) were lung cancer-related medical costs, and US$ 30,050 (21,077) were lung cancer-related costs during outpatient visits. Mean total monthly per-patient costs were US$ 44,678 among pembrolizumab plus platinum-based chemotherapy users (n=375), US$ 45,264 among pembrolizumab plus any chemotherapy users (n=392), US$ 45,682 among any chemotherapy plus any immunotherapy (n=396) users, US$ 33,371 among users of pembrolizumab only (n=257), US$ 31,774 among users of chemotherapy only (n=316), and US$ 31,119 among users of immunotherapy only (n=350). Overall, median TTD was 3.4 months (interquartile range [IQR]: 2.2, 6.1); patients receiving 1L chemotherapy only had shorter TTD (median: 2.4 months [IQR: 2.1, 3.7]) than patients in other subgroups.
CONCLUSIONS: HCRU and associated costs of 1LTs for a/mNSCLC may change over time; up-to-date information is important for informing reimbursement decisions for new 1LTs.
Conference/Value in Health Info
Value in Health, Volume 26, Issue 6, S2 (June 2023)
Code
EE43
Topic
Economic Evaluation
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)