HEALTH RESOURCE UTILIZATION (HRU) AND COSTS FOR METASTATIC RENAL CELL CARCINOMA (MRCC) PATIENTS TREATED WITH FIRST-LINE (1L) SYSTEMIC THERAPY IN THE UNITED STATES
Author(s)
Mhatre S1, Lin S1, Surinach A2, Vohra R1, Satram-Hoang S1, Simpson J1, Wallen H1, Ogale S1, Gong J3, Pal SK3, George DJ4
1Genentech, Inc., South San Francisco, CA, USA, 2Genesis Research, LLC, Hoboken, NJ, USA, 3City of Hope Comprehensive Cancer Center, Duarte, CA, USA, 4Duke University Hospital, Durham, NC, USA
OBJECTIVES: mRCC is associated with substantial economic burden, though limited data are available on individual HRU/cost components, which can facilitate appropriate resource allocation and inform health economic analyses. This study aimed to describe all-cause HRU/costs among mRCC patients, during 1L treatment and study follow-up, by drug class and administration route. METHODS: A retrospective cohort analysis was conducted using the MarketScan claims database (≈40 million US patients with employer-sponsored insurance). Patients with kidney cancer diagnosis claims (ICD-9=189.0) who initiated 1L mRCC therapy (sunitinib, sorafenib, pazopanib, axitinib, bevacizumab±, interferon, everolimus, temsirolimus or interleukin-2) during 2011-2013 were included; those with non-RCC histology or previous primary cancers were excluded. All-cause HRU/costs from 1L treatment start until end of follow-up were expressed in per patient per month (PPPM) units. Costs included all health plan- and patient-paid amounts from non–HMO-enrolled patients (adjusted to 2014 US$). RESULTS: Median age of mRCC patients (n=1,262) was 62 years; majority were male (70.4%) and in a PPO plan (52.5%). PPPM HRU and costs, respectively, were ≈9.7 and $13,583 during 1L treatment (median duration ≈6 months) and ≈8.3 and $10,992 over the follow-up period (median duration ≈10 months). PPPM costs during 1L treatment were 23.6% higher than those incurred during the entire follow-up period. 1L and follow-up costs, respectively, differed by drug class (TKI/VEGF: $12,249 and $10,911; mTOR: $14,096 and $11,406) and by dosage form (oral: $12,146 and $11,024; IV: $20,809 and $10,827). Cancer regimens (chemotherapy, cancer supportive drugs and administrative costs) accounted for most of the total costs (1L: 57.4%; follow-up: 47.4%), followed by outpatient services (1L: 21.3%; follow-up: 25.1%). CONCLUSIONS: Cancer regimens were the major contributor to all-cause HRU/costs, followed by outpatient services. HRU/costs differed by follow-up period, drug class and administration. These results provide historical control data from the pre-immunotherapy era to inform future health economic analyses.
Conference/Value in Health Info
2016-10, ISPOR Europe 2016, Vienna, Austria
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PCN256
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Urinary/Kidney Disorders