Economic burden in patients with ALK + non-small cell lung cancer, with or without brain metastases, receiving second-line anaplastic lymphoma kinase (ALK) inhibitors

Abstract

Jahanzeb (2020) Economic burden in patients with ALK + non-small cell lung cancer, with or without brain metastases, receiving second-line anaplastic lymphoma kinase (ALK) inhibitors,

Economic burden of brain metastases in non-small cell lung cancer patients in South Korea: A retrospective cohort study using nationwide claims data

“…In our study, PPPM costs in patients with BM comprised more inpatient costs than outpatient costs. This is consistent with previous studies that showed more PPPM costs in inpatient settings than in outpatient settings in patients with BM [ 19 , 20 ]. Moreover, as medications and radiation therapy have been suggested as the main cost drivers in patients with BM [ 19 ], drug costs comprised the greatest part of the total costs, followed by radiology/radiotherapy in our study.…”

“…This is consistent with previous studies that showed more PPPM costs in inpatient settings than in outpatient settings in patients with BM [ 19 , 20 ]. Moreover, as medications and radiation therapy have been suggested as the main cost drivers in patients with BM [ 19 ], drug costs comprised the greatest part of the total costs, followed by radiology/radiotherapy in our study. These greatest cost components were incurred in both inpatient and outpatient settings, with drug costs incurred mostly in outpatient settings and radiology/radiotherapy costs incurred mostly in inpatient settings.…”

“…The GLM results in our study are comparable to those of previous studies in the US. NSCLC patients who previously received crizotinib and ALK inhibitor treatment as second-line treatment had an average PPPM cost 1.37-fold higher than those without BM [ 19 ]. Another study analyzed claims data from the US to estimate the effect of alectinib on preventing BM in patients with ALK-positive NSCLC and found that ALK-positive NSCLC patients with BM accounted for approximately 1.32-fold higher PPPM costs than patients without BM [ 20 ].…”

“…To compare the demographic and clinical characteristics of the patients with and without BM before and after PS matching, we estimated the distribution of patients’ sex, age, non-cancer-related CCI, death, other cancers, and follow-up days for each group. We included these covariates based on previous retrospective studies that examined the economic impact of BM in NSCLC using claims data [ 19 , 20 ]. Data on sex and age reflected the information recorded on the index date for patients without BM and on the BM date for patients with BM.…”

“…Therefore, there could have been unavoidable differences in CCI between the two groups. To adjust for potential differences, we used non-cancer-related CCI by summing the scores without cancer-related items [ 19 ].…”