Real-World Costs of Adverse Events in First-Line Treatment of Metastatic Non-Small Cell Lung Cancer

• DOI: 10.18553/jmcp.2020.26.6.729
• Publication Date: 2020-05-28T17:49:35Z
• Authors: Nicole M. Engel-Nitz; Michael P. Johnson; Scott H. Bunner; Kellie J. Ryan
• Keywords: Aged, 80 and over; Male; Lung Neoplasms; Drug-Related Side Effects and Adverse Reactions; Cost-Benefit Analysis; Incidence; Health Care Costs; Middle Aged; Medicare; Survival Analysis; United States; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Cost of Illness; Carcinoma, Non-Small-Cell Lung; Antineoplastic Combined Chemotherapy Protocols; Humans; Female; Administrative Claims, Healthcare; Aged; Follow-Up Studies; Retrospective Studies

Non-small cell lung cancer (NSCLC) is the most common form of in United States. Immunotherapies and cytotoxic chemotherapies used to treat advanced NSCLC carry a substantial risk adverse events (AEs), but real-world data on incidence costs associated with unique AE profiles these treatments are sparse.To examine among patients initiating non-driver mutation-targeted first-line therapy for metastatic (mNSCLC) clinical practice.This was retrospective administrative claims study conducted commercial Medicare Advantage health plan members who initiated first-line, nontargeted systemic anti-NSCLC between January 1, 2008, February 28, 2018. Patients were assigned mutually exclusive treatment cohorts (cytotoxic chemotherapy [CHEM], immuno-oncology agents [IO], or + [IO-CHEM]) observed from index date (start therapy) through earliest disenrollment, death, March 31, rates care measured start new therapy, 180 days after end period. The factors influencing whether incurred high AE-related assessed using multivariable models adjusted patient demographic characteristics.The final population (mean [SD] age 68.6 [9.5] years, 53.9% male) included 8,818 CHEM cohort, 482 IO 412 IO-CHEM cohort. Overall, 74.4% had at least 1 during follow-up. rate lowest ratios (95% CI) 1.4 (1.3-1.6) cohort (1.2-1.6) Mean ($16,319) highest ($23,009; P < 0.001). In analysis, odds incurring any similar compared (OR = 0.82; 0.135 OR 0.98; 0.888, respectively). Among costs, those less likely than have 0.60; 0.030); difference not statistically significant.Among mNSCLC, receiving immunotherapy experienced fewer AEs lower total treated chemotherapy. Immunotherapy-treated no more chemotherapy-treated incur if they all. These findings indicate that immunotherapy-related differentiating factor cost this sponsored by AstraZeneca. Ryan an employee Engel-Nitz, Johnson, Bunner employees Optum, which contracted AstraZeneca conduct study, shareholders UnitedHealth Group. Engel-Nitz has also worked cancer-related studies Optum received funding Bayer AG, Clovis Oncology, Eli Lilly, EMD Serono, Exact Sciences, Janssen, Novartis. Johnson Medtronic, Sanofi, UnitedHealthcare. Celgene Incyte.