Trends and drivers of pharmaceutical expenditures from systemic anti-cancer therapy

• DOI: 10.1007/s10198-022-01515-0
• Publication Date: 2022-08-26T16:03:02Z
• Authors: Lars Børty; Rasmus F. Brøndum; Heidi S. Christensen; Charles Vesteghem; Marianne Severinsen; Søren P. Johnsen; Lars H. Ehlers; Ursula Falkmer; Laurids Ø. Poulsen; Martin Bøgsted
• Keywords: Lung Neoplasms; Expensive patients; Medicine expenditures; Breast Neoplasms; Comorbidity; 3. Good health; 03 medical and health sciences; Systemic anti-cancer therapy; 0302 clinical medicine; Oncology; Pharmaceutical Preparations; High utilizers; High-cost patients; Humans; Female; Health Expenditures; 0305 other medical science; Aged

Expenditures on medicine for systemic anti-cancer therapy (SACT) have seen large increases in recent years. The characterization of patients with high SACT costs is crucial to identify cost-driving factors, but little is known about the distribution of expenditures at the patient-level. We priced 260,834 registrations of SACT for 12,589 patients from 2008 to 2019 by combining them with product-level billings of EUR 142.1 million. Based on this, we defined high-cost patients as the 2.5% most expensive by accumulated SACT expenditures. We found that high-cost patients accounted for 28.8% of the total SACT expenditures and were observed across all major cancer groups except for pancreatic cancer. The risk of becoming a high-cost patient was increased for younger age groups, i.e., 18-44 and 45-64 years, for patients with BMI ≥ 25, and for patients with multiple cancer diagnoses, while no alteration of risk was observed due to comorbidities or sex. Changes in the characteristics of high-cost patients during the study period were found with an increased risk of becoming high-cost in later years for elderly patients and patients with lung cancer and a decreased risk for breast cancer patients.