Costs of First-Line Doublet Chemotherapy and Lifetime Medical Care in Advanced Non–small-Cell Lung Cancer in the United States

Lang, Kathleen; Marciniak, Martin; Faries, Douglas E.; Stokes, Michael; Buesching, Don P.; Earle, Craig C.; Treat, Joseph; Babineaux, S.M.; Morissette, N.; Thompson, David A.

doi:10.1111/j.1524-4733.2008.00472.x

Cited by 22 publications

(17 citation statements)

References 17 publications

(18 reference statements)

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“…Also, more recent increases in spending for advanced lung cancer may reflect not only changes in detection and staging techniques and management over time, but also increased use of chemotherapy and targeted therapies. Three studies were identified that examined the cost of advanced lung cancer using the linked SEER-Medicare claims data [4,7,9]. Yabroff and colleagues reported that costs of care during the last year of life among patients with distant lung cancer averaged $85,392 (in 2010 USD); hospitalization costs were the single largest component of cost among these patients.…”

Section: Discussionmentioning

confidence: 99%

“…While a few retrospective longitudinal studies [7-11] have estimated the cost of metastatic lung cancer in the US, these studies employed varied designs and methods (i.e., in terms of patient populations, disease definitions, and measure of healthcare costs), did not track lifetime healthcare resource use and costs, or did not analyze cost components by setting or type of service. Up-to-date data on resource use and costs among patients with metastatic lung cancer -- overall and by constituent component -- thus may help inform current decision-making about the optimal allocation of healthcare resources.…”

Section: Introductionmentioning

confidence: 99%

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Healthcare costs in patients with metastatic lung cancer receiving chemotherapy

Vera-Llonch

Weycker

Glass

et al. 2011

BMC Health Serv Res

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BackgroundTo characterize healthcare resource utilization and costs in patients with metastatic lung cancer receiving chemotherapy in the US.MethodsUsing data from a large private multi-payer health insurance claims database (2000-2006), we identified all patients beginning chemotherapy for metastatic lung cancer. Healthcare resource use (inpatient, outpatient, medications) and costs were tallied over time from date of therapy initiation ("index date") to date of disenrollment from the health plan (in most instances, presumably due to death) or the end of the study period, whichever occurred first. Healthcare utilization and costs were characterized using Kaplan-Meier sample average methods.ResultsThe study population consisted of 4068 patients; mean (SD) age was 65 (11) years. Over a median follow-up of 334 days, study subjects averaged 1.5 hospital admissions, 8.9 total inpatient days, and 69 physician office and hospital outpatient visits. Mean (95% CI) cumulative total healthcare costs were $125,849 ($120,228, $131,231). Costs of outpatient medical services and inpatient care constituted 34% and 20% of total healthcare costs, respectively; corresponding estimates for outpatient chemotherapy and other medication were 22% and 24%.ConclusionOur study sheds additional light on the burden of metastatic lung cancer among patients receiving chemotherapy, in terms of total cost thru end of life as well as component costs by setting and type of service, and may be useful in informing medical resource allocation in this patient population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Healthcare costs in patients with metastatic lung cancer receiving chemotherapy

Vera-Llonch

Weycker

Glass

et al. 2011

BMC Health Serv Res

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“…Other aNSCLC studies reported costs of first-line therapy ranging from US$22,126 to US$31,104 [8] and US$28,562-34,516 [7] versus US$84,671 in this study. The costs results from the earlier studies are based primarily on chemotherapy doublet regimens for Medicare patients prior to 2004.…”

Section: Research Article Henk and Raymentioning

confidence: 91%

Section: Research Article Henk and Raymentioning

confidence: 99%

“…The most recent real-world estimates of the cost of systemic treatment of aNSCLC in the USA are based primarily on data from 1998 to 2006 [6][7][8]. These studies either did not distinguish costs by treatment regimen [6] or were limited to first-line therapies (primarily platinum-based doublets) commonly prescribed during that period [7,8]. Studies of second-line therapy costs were limited to monotherapy treatment of all lung cancers [9], monotherapy treatment of aNSCLC (outpatient costs only) [10] or predated approval/clinical adoption of targeted therapies and pemetrexed [3].…”

Section: Research Article Henk and Raymentioning

confidence: 99%

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Treatment Patterns and Healthcare Costs among Patients with Advanced Non-Small-Cell Lung Cancer

Henk

Ray

2013

Lung Cancer Manage.

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Aim: To identify contemporary first-and second-line treatment patterns for advanced non-small-cell lung cancer (aNSCLC) and associated costs. Methods: This study identified aNSCLC patients through an oncology registry linked to a large US commercial claims database. Patients with aNSCLC (stage IIIb or IV) and continuous enrollment in the health plan from diagnosis until death were included. First and second lines of therapy and their associated costs were determined. Results: The most common first-line regimens (n = 335) were platinum-taxane doublets alone (29%) or in combination with bevacizumab (14%) or pemetrexed (6%). Most second-line regimens (n = 74) contained pemetrexed, Background ū Treatment options for patients with advanced non-small-cell lung cancer (aNSCLC) have been expanding with the development of predictive biomarkers and biologically targeted treatments.ū This study coupled US healthcare claims data with cell type and disease stage information from an oncology registry to assess contemporary systemic treatment patterns for patients with aNSCLC in clinical practice. Treatment patterns & healthcare costsū Platinum-taxane doublet regimens were the most common first-line treatment (29%), followed by bevacizumab plus platinum-taxane doublets (14%). Two or more newer agents (bevacizumab, erlotinib and/or pemetrexed) were included in 16% of first-line regimens. ū The majority of second-line regimens (76%) included bevacizumab, erlotinib and pemetrexed. ū Total healthcare costs varied widely depending on regimen, ranging from US$19,812 to US$167,847 for first-line regimens and US$35,737 to US$135,364 for second-line regimens. ū Systemic therapy represented 20-55% of total first-line costs and 22-68% of total second-line costs. Conclusion ū These results demonstrate the emerging use of targeted agents and the potential cost implications of systemic treatments for aNSCLC. Summary PointsTreatment patterns and healthcare costs among patients with advanced non-small-cell lung cancer

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