Cost of care in first line advanced NSCLC patients: Chemotherapy vs targeted therapy

Date

08 Oct 2016

Session

Poster Display

Presenters

Janna Radtchenko

Citation

Annals of Oncology (2016) 27 (6): 416-454. 10.1093/annonc/mdw383

Authors

J. Radtchenko1, B. Korytowsky2, K. Tuell3, M. Bhor4, B. Feinberg5

Author affiliations

  • 1 Heor, Cardinal Health, 43017 - Dublin/US
  • 2 Outcomes Research, Bristol-Myers Squibb, Princeton/US
  • 3 Hsor, Bristol-Myers Squibb, Princeton/US
  • 4 Heor, Cardinal Health, Dublin/US
  • 5 Oncology, Cardinal Health, Dublin/US
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Resources

Background

Targeted therapies have increasingly placed drug cost in the spotlight. This represents only one aspect of cancer treatment cost. To provide a comprehensive view, we analyzed first-year drug costs, procedures and acute care interventions for a NSCLC patients on chemo vs TT in the 1L setting.

Methods

Using Inovalon's MORE2 Registry® US claims data, aNSCLC pts were identified by International Classification of Diseases-9 codes from July 2013 to June 2014. Inclusion: aNSCLC pts >18 years who received 1L systemic therapy within 6 months (mo) of diagnosis. Exclusion: pts with small-cell lung cancer or secondary malignancies, clinical trial pts, pts with

Results

Of 5319 1L pts, 1070 (20%) had ≥12 mo of follow-up and were included in the analysis. Of those, 23% received TT (242 pts); 62% (659 pts) incurred inpatient costs. Results of the analysis are presented in the table.

All pts (N = 1070) Pts with inpatient costs (N = 659) TT pts (N = 242) Chemo pts (N = 828)
Mean follow-up, mo 20.3 21.3 21.2 20.1
Mean 1L TC, $ 110,138 118,898 150,272 100,624
Mean 1L TC monthly, $ 5,414 5,595 7,086 4,996
Outpatient costs and subcategories
Outpatient costs, % 87 79 92 86
Systemic therapy 27 21 59 19
Supportive care 11 10 2 14
Office visits 2 2 2 2
Labs & diagnostics 2 2 2 2
Radiation/surgery 2 2 1 2
Other drugsa 26 26 18 28
Other procedures 17 16 9 19
Inpatient costs, % 13 21 8 14

aMay not have been related to a NSCLC

Conclusions

The study showed considerable TC in 1L aNSCLC, with systemic therapy representing a significant share. Pts with inpatient care incurred higher TC, and chemo pts had a higher share of inpatient costs vs TT pts. Alternatives to traditional chemo may allow for savings across non-drug-related outpatient and inpatient costs.

Clinical trial identification

Legal entity responsible for the study

Bristol-Myers Squibb

Funding

Bristol-Myers Squibb

Disclosure

J. Radtchenko: Participation in funded or unfunded research on a technology, process, or product development or are the principal investigator for a project related to research from Cardinal Health, analyst and study director. B. Korytowsky, K. Tuell: Employment and Stock or Other Ownership from BMS. All other authors have declared no conflicts of interest.

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