OBJECTIVES : To describe patient characteristics, treatment patterns, healthcare resource utilization (HRU) and costs of newly diagnosed Merkel Cell Cancer (MCC) patients in the US.

METHODS : Newly diagnosed MCC patients were identified by ICD-9 codes for MCC 209.31 - 209.36 or 209.75 between July 2010 and December 2014 in MarketScan administrative claims databases. All HRU and costs were standardized and reported in 2017 US$ at the median per patient per year (PPPY) level.

RESULTS : A total of 599 (27.5%) patients received first line (1L) chemotherapy. Of these, 15.5% (n=93) also received second line (2L) and of these, 10.8% (n=10) received third line (3L) treatment. There was considerable outpatient service utilization across all lines of treatments (LOTs). 92.7% (1L), 89.3% (2L), and 100% (3L) of patients had ≥1 office visit; median PPPY visits were 26.1 (Q1-Q3: 15.9; 39.1) in 1L, 26.1 (Q1-Q3: 19.2; 44.7) in 2L and 30.7 (Q1-Q3: 18.3; 52.2) in 3L. Median medical costs PPPY for all patients (n=2,177) were $38,977 (Q1-Q3: 14,356; 98,015). For patients receiving chemotherapy, the overall median costs PPPY by LOT were: 1L $121,102 (Q1-Q3: 48,369; 226,013), 2L $130,760 (Q1-Q3: 57,794; 209,568) and 3L $173,413 (Q1-Q3: 78,685; 281,994) with outpatient care accounting for 72.5%, 66.2%, and 79.8% respectively.

CONCLUSIONS : This retrospective real-world study provides new insights into the pattern and cost of care of newly diagnosed MCC patients in the US. Costs, driven mainly by outpatient care, were high among patients undergoing chemotherapy treatment. New therapies including recently approved immuno-oncology agents may provide additional treatment options for this mainly elderly MCC patient population.