1417P - Change in healthcare resource use and associated costs of patients with metastatic lung cancer between 2013 and 2019: An observational study from the French national claims database

Background

Treatment landscape in metastatic lung cancer is quickly evolving, including targeted therapies and immunotherapies. Both treatments have shown improved survival but are also associated with increased costs. This study aimed to describe the evolution of costs associated with metastatic lung cancer in France.

Methods

From the French national claims database (SNDS), a dynamic cohort of patients identified between 2013 and 2019 with metastatic lung cancer and a marker for the presence of metastases (ICD-10 code or at least one reimbursement for Bevacizumab or Pemetrexed) was constituted. Healthcare resource use was described each calendar year through the percentage of patients with at least one record for each expenditure item. The associated costs were reported monthly and estimated from the health insurance perspective. The trend over the study period for the total mean monthly cost was studied using Joinpoint software.

Results

Between 2013 and 2019, 116 686 patients with a metastatic lung cancer were identified (67.1% of men, median age of 65 years). The percentage of patients with at least one overnight hospitalization decreased from 85.2% in 2013 to 67.6% in 2019 while the use of day hospitalizations remained stable (about 40%). The percentage of patients with outpatient care increased over the study period: medical visits (from 82.6% to 88.0%), lab tests (from 74.1% to 83.5%), medical procedures (from 72.0% to 83.2%). The total mean monthly cost per patient decreased between 2013 and 2019 (from 5,683€ to 4,653€), by 2.85% per year (95%CI: -4.13 to -1.56, p<0.0001). An increase in drugs acquisition costs (from 1,015€ to 1,365€) and a decrease in the cost of overnight hospitalizations (from 3,110€ to 1,990€) were observed.

Conclusions

This study highlights that the increase in drugs acquisition costs has been offset by a decrease in hospitalization costs, resulting in a decrease in global management costs of patients with metastatic lung cancer in France between 2013 and 2019. These findings may be the result of French health policy and may also be related to improved disease management.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

MSD France.

Funding

MSD France.

Disclosure

C. Chouaid: Financial Interests, Personal, Advisory Board: AZ, BI, GSK, Roche, Sanofi Aventis, BMS, MSD, Lilly, Novartis, Pfizer, Takeda, Bayer, Janssen, Amgen; Financial Interests, Institutional, Funding: AZ, BI, GSK, Roche, Sanofi Aventis, BMS, MSD, Lilly, Novartis, Pfizer, Takeda, Bayer, Janssen, Amgen. C. Marchal: Financial Interests, Personal, Full or part-time Employment: PELyon; Financial Interests, Institutional, Funding: MSD France. M. Apert: Financial Interests, Personal, Full or part-time Employment: MSD France; Financial Interests, Personal, Stocks/Shares: MSD France. L. Bensimon: Financial Interests, Personal, Stocks/Shares: MSD France. V. Guimard: Financial Interests, Personal, Full or part-time Employment: MSD France. M. Née: Financial Interests, Personal, Full or part-time Employment: PELyon; Financial Interests, Institutional, Funding: MSD France. M. Belhassen: Financial Interests, Personal, Full or part-time Employment: PELyon; Financial Interests, Institutional, Funding: MSD France. G. de Pouvourville: Financial Interests, Personal, Advisory Board: MSD France. J. Blay: Financial Interests, Personal, Advisory Board: Bayer, Deciphera, GSK, Roche; Financial Interests, Personal, Invited Speaker: PharmaMar; Financial Interests, Institutional, Invited Speaker: MSD, MSD; Financial Interests, Personal, Other, member of the supervisory board: Innate Pharma; Financial Interests, Institutional, Funding: MSD, BMS, Deciphera; Financial Interests, Institutional, Research Grant: AstraZeneca, Roche, Bayer, GSK, Novartis, Ose Pharma.