91P - Territorial disparities in the use of hospitalization at home for immune checkpoint inhibitors infusion in France between 2021 and 2022

Background

Immune Checkpoint inhibitors (ICI) administration at home is considered as a development priority by the French society of cancer immunotherapy and French government with “ma santé 2022” program. The study objective was to analyze the territorial development of ICI infusions at home between 2021 and 2022.

Methods

The national hospital databases from the French statutory health insurance were used to identify all patients treated by ICI and to build a cohort of patients with at least one administration in Hospitalization At Home (HAH). All ICI administrations were collected retrospectively up to 2016. A descriptive analysis was performed to characterize patients, centers and "HAH patients" care pathways (based on treatment sequences clustering algorithms) and administration costs in the French statutory health insurance perspective.

Results

Over 2021 and 2022, 652 ICI (0.6%) patients were treated in HAH. Primary diagnosis among HAH patients were lung cancer with 51% (26%-78% depending on regions), followed by metastatic melanoma with 17%, (1%-18%). The three main regions were Ile de France (IDF), Auvergne Rhône Alpes (AURA) and Nouvelle Aquitaine (NA), with 543 patients (83% of HAH patients). The proportion of HAH patients per region varied from 0.1% to 1.6%. Mean age were similar between regions in main indications, from 65 to 69 years old in lung cancer regions and 68 in metastatic melanoma regions. Men proportion varied in lung cancer (6.6% - 31.8%) and were similar in metastatic melanoma (38.1% - 40.5%). Care pathways’ characteristics and costs per HAH infusion in main indications heavily differed per region (Table). Table: 91P

HAH patients’ and care pathways’ characteristics, and cost of HAH infusion, in the 3 main regions per indication

STD: Standard Deviation * <11 patients : sample results not presented

Conclusions

Patient pathways depended on indication and differed according to regions. Further analyses on healthcare resources will allow to understand how optimizing HAH use for ICI patients in France.

Legal entity responsible for the study

Bristol Myers Squibb.

Funding

Bristol Myers Squibb.

Disclosure

A.C. Toffart, G. Casanova: Financial Interests, Personal, Advisory Board: BMS. M. Pierre, H. Lemasson, V. Moreau-Mallet, M. Chartier: Financial Interests, Personal, Affiliate: BMS. N. Pagès, R. Jolivel, A. Panès: Financial Interests, Personal, Financially compensated role: BMS. M. Pérol: Financial Interests, Personal, Advisory Board, Advisory Board: Roche, AstraZeneca, MSD, BMS, Lilly, Novartis, Takeda, Gritstone, Sanofi, Pfizer, Amgen, Janssen, GSK, Eisai, Ipsen, Novocure, AbbVie, Anheart Therapeutics, Daiichi Sankyo; Financial Interests, Personal, Invited Speaker, Symposium: Roche, AstraZeneca, MSD, BMS, Boehringer Ingelheim, Takeda, Illumina, Pfizer, Medscape; Financial Interests, Personal, Advisory Board, Expert Testimony: AstraZeneca; Financial Interests, Personal, Steering Committee Member, Steering Committee Member: Lilly; Financial Interests, Institutional, Local PI, Local PI: AbbVie, Amgen, Anheart Therapeutics, Apollomics, Arrivent Biopharma, AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Innate Pharma, Roche; Financial Interests, Institutional, Research Grant, Research Grant: AstraZeneca, Boehringer Ingelheim, Roche, Takeda; Financial Interests, Personal, Trial Chair, Trial Chair: Anheart Therapeutics; Financial Interests, Personal, Steering Committee Member, Idmc Chair: PharmaMar, Sophiagenetics; Financial Interests, Personal, Steering Committee Member, Steering Committee Member: Roche; Financial Interests, Personal, Other, DMSB: Roche.