Elderly with aNSCLC represents a population at higher risk of severe adverse events (AEs) due to poorer performance status and more comorbidities than younger patients (pts). Severe AEs may also impose a financial burden on the healthcare system. In a cohort of elderly pts with aNSCLC who received second-line therapy (2L), we assessed the impact of severe AEs on healthcare costs.
The SEER-Medicare database was used to identify pts with aNSCLC aged ≥65 years diagnosed between 2007-11 who initiated 2L up to end of Medicare data availability of 12/31/2013. Pts were divided into 2 cohorts of with and without severe AEs during time on 2L therapy. 57 AEs were pre-specified based on literature review and oncologist consult. Severe AEs were defined as AEs requiring a hospitalization. The incremental impact of severe AEs on all-cause healthcare costs incurred during 2L was estimated using two-part regression models adjusted for age, sex, region, stage at diagnosis (dx), and overall disease burden at 2L start.
Of 3,967 pts who initiated 2L, 1,624 (41%) had ≥1 severe AE. Use of chemotherapy only or targeted therapy-based regimens were comparable between cohorts. Both cohorts had similar demographic and cancer characteristics at dx, but some comorbidities were more prevalent in pts with severe AEs during the period between the aNSCLC dx and 2L initiation (anemia 69% vs 60%; weight loss 27% vs 20%, renal failure 15% vs 11%, congestive heart failure 25% vs 17%, bleeding 35% vs 31%, all p
AEs resulting in hospitalizations are associated with a high economic and pt burden. New treatments with safer profiles are needed to improve pt outcomes.
Clinical trial identification
Legal entity responsible for the study
Y.M. Yim, M. Gandhi: Yeun Mi Yim is an employee of Genentech, Inc., a member of the Roche Group, and owns stock/stock options. A. Guerin, R. Ionescu-Ittu, I. Pivneva, S. Shi, E. Wu: Employee of Analysis Group, Inc., which has received consultancy fees from Genentech, Inc.: