OBJECTIVES: Long-term real-world resource utilization and cost data of mCRC patients eligible for targeted therapies are still scarce. Therefore, more information on treatment cost in current treatment pathways is required to allow informed decision making regarding targeted therapies.

METHODS: Treatment data for patients with mCRC were extracted from the IMS^® Oncology Analyzer (OA) database. Based on this, cost for mCRC therapies of currently treated patients were assessed from the perspective of the German Statutory Health Insurance (SHI), using a micro-costing approach.

RESULTS: Treatment pathways from 314 patients who had at least two documented lines of therapy were evaluated. 90% of these patients had been tested for RAS status. RAS testing rates for patients with only one documented line of therapy decreased over time from 71% (2014) to 50% (2016). Data show that RAS wildtype (RAS-WT) patients predominantly received Anti-EGFR treatment whereas RAS mutant (RAS-MT) patients mainly received bevacizumab-based therapy. After 1^st line therapy, 82% of RAS-WT patients and 20% of RAS-MT patients switched from one targeted therapy to another in 2^nd line therapy.

For cost analysis data from 1,343 patients with at least one line of treatment was used. Total mean treatment cost for currently treated patients with RAS-WT (€ 19,733) was 10% higher than for RAS-MT patients (€ 18,003). Compared to a similar analysis in 2014, the difference in treatment cost between RAS-WT and RAS-MT patients have decreased by more than 5%.

CONCLUSIONS: Knowledge of RAS status of mCRC patients affects treatment decisions and allows additional treatment options for RAS-WT patient that are only available for patients who had been tested. Differences in treatment cost for RAS-WT and RAS-MT patients have decreased between 2014 and 2016. The decrease in the RAS testing rate needs to be assessed further to allow best possible treatment for mCRC patients.