The Impact of Adverse Events on Health Care Resource Utilization, Costs, and Mortality Among Patients Treated with Immune Checkpoint Inhibitors

Abstract

Background. We investigated the association between adverse events (AEs) suspected to be immune-related and health care resource utilization, costs, and mortality among patients receiving programmed cell death 1/programmed cell death ligand 1 immune checkpoint inhibitor (ICI) monotherapy for urothelial carcinoma, renal cell carcinoma, non-small cell lung cancer, or Merkel cell carcinoma. Patients and Methods. We conducted a retrospective cohort study using medical and pharmacy claims and enrollment information from U.S. commercial and Medicare Advantage with Part D enrollees in the Optum Research Database from March 1, 2014, through April 30, 2019. Claims were linked with mortality data from the Social Security Death Index and the National Death Index. Eligible patients had at least one ICI claim between September 1, 2014, and April 30, 2019.Results. After adjusting for potential confounding variables, we found patients with AEs had more than double the risk of an inpatient stay (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.9-2.5) and an 80% higher risk of an emergency visit (HR,

Incidence and Costs of Clinically Significant Events with Systemic Therapy in Patients with Unresectable Hepatocellular Carcinoma: A Retrospective Cohort Study

“…The occurrence of AEs, including CSEs, following treatment with systemic therapy, has been associated with a decrease in HRQoL in patients with HCC [ 24 ]. Given the high cost of CSEs and their potential impact on patients’ HRQoL, patients with uHCC who are treated with systemic therapy should be frequently evaluated for CSEs to enable early detection [ 25 ]. This will enable more effective multidisciplinary management in order to improve patient outcomes and reduce the need for costly pharmacy services and inpatient stays [ 25 ].…”

“…Given the high cost of CSEs and their potential impact on patients’ HRQoL, patients with uHCC who are treated with systemic therapy should be frequently evaluated for CSEs to enable early detection [ 25 ]. This will enable more effective multidisciplinary management in order to improve patient outcomes and reduce the need for costly pharmacy services and inpatient stays [ 25 ]. A previous study demonstrated that experience in the management of sorafenib-related AEs can prolong survival and treatment duration in patients with HCC, highlighting the importance of effective AE management in this setting [ 26 ].…”

Assessing the impact of digital patient monitoring on health outcomes and healthcare resource usage in addition to the feasibility of its combination with at-home treatment, in participants receiving systemic anticancer treatment in clinical practice: protocol for an interventional, open-label, multicountry platform study (ORIGAMA)

“…For instance, patients with urothelial carcinoma, renal cell carcinoma, non-small cell lung cancer (NSCLC) or Merkel cell carcinoma receiving immune checkpoint inhibitor therapy and experiencing treatment-related symptoms/AEs have an increased risk of unplanned hospitalisations and emergency room visits, and increased overall healthcare costs, compared with those without treatment-related symptoms/AEs. 7 In addition, the financial burden of using prescription medications and allied healthcare professionals (eg, physiotherapists, dieticians) to manage anticancer treatment-related symptoms/AEs can be a significant source of out-of-pocket patient expenses, which have not been well documented thus far. 8 Overall, there is a strong need for improved, patient-empowered management of cancer and anticancer treatment-related symptoms/AEs that may compromise improvements in patient outcomes or consume healthcare/financial resources.…”

“…Furthermore, treatment-related symptoms can be burdensome to patients, healthcare professionals and healthcare system resources. For instance, patients with urothelial carcinoma, renal cell carcinoma, non-small cell lung cancer (NSCLC) or Merkel cell carcinoma receiving immune checkpoint inhibitor therapy and experiencing treatment-related symptoms/AEs have an increased risk of unplanned hospitalisations and emergency room visits, and increased overall healthcare costs, compared with those without treatment-related symptoms/AEs 7. In addition, the financial burden of using prescription medications and allied healthcare professionals (eg, physiotherapists, dieticians) to manage anticancer treatment-related symptoms/AEs can be a significant source of out-of-pocket patient expenses, which have not been well documented thus far 8.…”