Abstract 1518P
Background
Cancer of unknown primary (CUP) is a cause of major morbidity and mortality. Still, only limited information on epidemiology, treatment and economic data with regards to CUP syndrome exists. The objective of this study is to project economic consequences associated with treating CUP in Germany and to identify factors that drive the economic outcomes.
Methods
This is a retrospective cohort study based on anonymized German claims data (InGef research database). Observation period: 2014 - 2019. Inclusion criteria: ≥18y, inpatient or outpatient diagnosis of CUP per year (prevalent patients; ICD-10-Code: C80).
Results
The number of documented CUP per 100.000 increased between 2014 – 2019 by 47% (2014: 226; 2019: 332); a rate of 8% per year. Age and sex did not change over 5 years, mean 71 years (73; 18 - 104) and 52% male (2019). The TOP-5 antineoplastic and immunomodulating agents (ATC code L) were similar between 2014 - 2019 (Platinum-containing compounds, Pyrimidine analogues, Monoclonal antibodies, Taxane, Colony stimulating factors). Percentage, number and length of hospitalization were comparable (2014-2019): 84% were inpatient; mean 3 admissions (2; 0 – 25) and mean 19 days ppt (4; 0 - 365) in 2019. Mean costs were €12.894 ppt in 2014 (5.319; 0 – 457.248) and €14.148 in 2019 (6.139; 0 – 600.558). The proportion of costs in 2019 exemplary: inpatient care 46%, medicines 33%, outpatient care 13% and therapeutic aids 7%. Total annual mean costs increased by 76% between 2014 - 2019. Approximately 13% of all patients died in 2014 and 10% in 2019.
Conclusions
From a payers’ perspective, with more documented CUP cases, annual costs increased over the study period. The wide cost range reflects the heterogeneity of CUP syndrome and its management. Claims data were associated with some common limitations with regards to line of therapy or the identification of a primary tumour after a certain time. Furthermore, claims data do not include patient-reported outcomes. To allow for comprehensive health economic and outcome analyses, such information would be essential. Accordingly, future efforts should aim at different data sources, e.g. registries, electronic patient records, in order to provide a holistic view of treatment patterns, outcomes and costs.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Roche.
Disclosure
C.B. Westphalen: Financial Interests, Personal, Invited Speaker: Bayer; Financial Interests, Personal, Other, Travel Support: Bayer; Financial Interests, Personal, Invited Speaker: BMS; Financial Interests, Personal, Advisory Board: BMS; Financial Interests, Personal, Advisory Board: Celgene; Financial Interests, Personal, Invited Speaker: Celgene; Financial Interests, Personal, Other, Travel Support: Celgene; Financial Interests, Personal, Invited Speaker: GSK; Financial Interests, Personal, Advisory Board: Rafael; Financial Interests, Personal, Other, Travel Support: RedHill; Financial Interests, Personal, Advisory Board: RedHill; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Other, Travel Support: Roche; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Other, Travel Support: Servier; Financial Interests, Personal, Invited Speaker: Servier; Financial Interests, Personal, Advisory Board: Shire/Baxalta; Financial Interests, Personal, Invited Speaker: Sirtex; Financial Interests, Personal, Other, Travel Support: Taiho; Financial Interests, Personal, Invited Speaker: Taiho; Non-Financial Interests, Personal and Institutional, Research Grant: Roche; Non-Financial Interests, , Officer: AIO - Arbeitsgemeinschaft Internistische Onkologie (Germany). All other authors have declared no conflicts of interest.