NSCLC Treatment Cost Significantly Increases Over 7-Year Span

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The cost of treating non–small cell lung cancer (NSCLC) has shown significant increases over time, irrespective of the stage of disease. This is particularly true for younger patients treated in the outpatient setting, according to real-word findings.¹

“This study illustrates the value of combining electronic medical record information with claims data, said Nicholas Robert, MD, chief medical officer, Ontada told Targeted Oncology. “In this way we have observations can be made that can provide insights in terms of cancer management.”

These results come from electronic health record data from patients with NSCLC who were treated at US Oncology Network locations between March 2015 and June 2022. To conduct the analysis, data were pulled using the iKnowMed™ oncology-specific electronic health records, which offer information from roughly 40% of patients treated at community practices in the United States (US) and is linked to claims and remittance data.

Results from 26,615 patients treated across the US showed that the per-patient-per-month (PPPM) cost of treatment climbed from $2,745 in 2015 to $5,831 in 2022, according to the descriptive analysis. These findings were confirmed with an adjusted analysis. When investigators looked at PPPM cost in patients with stage IV disease vs those with stage 0-III disease, the cost was higher for patients with advanced disease. In 2015 the difference in cost between the 2 groups was $2,313. By 2022, the difference in cost between patients with early-stage disease and those with advanced-staged disease was $3,955. PPPM cost of care for patients aged < 65 years was $5,784 compared with $4,550 among patients aged 85 years or older.

Evaluating the cost of care and how these costs have changed overtime was the overall goal when reviewing the data from patients with NSCLC who were treated at US Oncology Network. The costs were defined as the paid amount for outpatient services in US dollars. These costs were descriptively assessed as the longitudinal cost PPPM since 2015.

The study population had a median age of 68 years (range, 61-75 years). The population was 48% male and 52% female, and most patients were White (71%). Black patients and Asian patients made up 9% and 2% of the population, respectively. All other patients were identified as another race, or no racial or ethnic information was documented for them.

Notably, 43% of the population was from the Southern US, 29% were from the West, 22% from the Midwest, and 6% from the Northeast. Ninety-three percent of the population was made up of patients from urban areas, 50% of whom had commercial insurance, and 43% of whom had Medicare. The remainder of the patients had Medicaid as their insurance provider (7%) or other (< 1%).

All patients had previously been treated with chemotherapy, and the majority had stage IV disease (40%). Twenty-six percent of patients had stage 0-III disease, and disease stage was not documented for 34%.

Investigators also evaluated outpatient PPPM cost by characteristics. Notably, PPPM cost was lower for male patients ($5,827) compared with female patients ($4,611). Cost was consistent among the various racial groups.

An assessment of PPPM cost by region showed that patients treated in the Northeast paid the least amount for their care ($4,996), and patients treated in the West paid the most ($5,302).Patients who were treated in urban areas of the US had higher PPPM costs ($5,285) vs rural patients ($4,318).

In terms of PPPM cost based on insurance type, patients with Medicaid had the lowest cost ($4,708), and patients with commercial insurance paid the most ($5,704).

Year of diagnosis was also affected the PPPM cost of treatment for NSCLC. The PPPM cost of treatment in 2015 was $2,746, compared with $5,831 in 2022. Treatment was the highest in 2020 at $6,937 PPPM. Fourteen percent of the patients were treated in 2020.

This research may provide information on how advances in the NSCLC space have impacted the cost of treatment, according to the investigators.

_REFERENCE:

_{Su Z, Espirito J, Aguilar KM, et al. Real-World outpatient cost of care among patients with non-small cell lung cancer (NSCLC) treated in the US community. Presented at: 2023 International Society for Pharmacoeconomics and Outcomes Research; May 7-10, 2023. Boston, MA. Abstract EE499.}