Health care resource utilization and costs of Medicare-enrolled patients with HR+/HER2-metastatic breast cancer treated with a CDK4/6i in the first-line setting

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作者
Behan, Emma [1 ]
Veenstra, David L. [1 ]
Bansal, Aasthaa [1 ]
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[1] Univ Washington, Comparat Hlth Outcomes Policy & Econ CHOICE Inst, Dept Pharm, Seattle, WA 98195 USA
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R19 [保健组织与事业(卫生事业管理)];
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BACKGROUND: The introduction of cyclin-dependent kinases 4 and 6 inhibitors (CDK4/6is) has transformed the treatment landscape for patients with hormone receptor positive (HR+) and human epidermal growth factor receptor 2 negative (HER2-) metastatic breast cancer (MBC). To our knowledge, no studies have quantified health care resource utilization (HRU) or economic burden following CDK4/6i initiation in the Medicare population. OBJECTIVE: To describe HRU and quantify health care costs among Medicare-enrolled patients with HR+ HER2- MBC treated with CDK4/6is in the first-line setting. METHODS: We conducted a retrospective cohort study on Medicare- enrolled patients with HR+ HER2- MBC who initiated a CDK4/6i in the first-line setting between February 2, 2016, and December 31, 2022, using claims from the Merative MarketScan database. We examined all-cause HRU by summarizing the number of inpatient (IP), outpatient (OP), and emergency department (ED) visits as well as the length of stay during the 6 months following CDK4/6i initiation. Additionally, we assessed all-cause health care costs, including IP, OP, ED, and pharmacy, over the 1 year following CDK4/6i initiation using the Kaplan-Meier sample average estimator to account for censoring. We reported total health care costs as the sum of IP, OP, ED, and pharmacy costs. RESULTS: 901 patients met the inclusion criteria with a mean age of 74 years (SD = 6.84). Nearly 24% (n = 214) had an IP admission in the 6 months following CDK4/6i initiation. Among patients with an IP admission, the mean number of admissions per patient was 1.65 (SD = 0.98) with a mean length of stay per admission of 5.98 (SD = 6.25) days. Roughly 30% (n = 271) of patients had an ED visit, with a mean of 2.1 (SD = 1.54) visits per patient among those who had a visit. Most patients (n = 868, 96.44%) had an OP service, and among those with an OP service, the mean number of days with OP services was 19.96 (SD = 12.29). Mean total health care costs over the 1-year period following CDK4/6is were $62,228 (95% CI = 52,281-73,029) per patient with the main drivers being OP services ($31,686 [95% CI = 27,16836,925]) and pharmacy costs ($22,727 [95% CI = 19,273-25,931]). CONCLUSIONS: There are numerous sources of HRU and cost in patients following CDK4/6i initiation in the Medicare population. Patients with HR+ HER2- MBC incur high HRU, providing insights for health care decision-makers to optimize treatment strategies and resource allocation for this population.
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页码:6 / 14
页数:9
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共 23 条
[1]  
[Anonymous], 2022, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP): Health and economic costs of chronic diseases
[2]  
[Anonymous], Merative MarketScan Research Databases 2022
[3]  
[Anonymous], 2024, Measuring price change in the CPI: Medical care
[4]   Comparison of healthcare resource utilization and costs of patients with HR+/HER2-advanced breast cancer treated with ribociclib versus other CDK4/6 inhibitors [J].
Burne, Rebecca ;
Balu, Sanjeev ;
Guerin, Annie ;
Bungay, Rebecca ;
Sin, Roxana ;
Paul, Mary Lisha .
JOURNAL OF MEDICAL ECONOMICS, 2021, 24 (01) :806-815
[5]   VALIDATION OF A COMBINED COMORBIDITY INDEX [J].
CHARLSON, M ;
SZATROWSKI, TP ;
PETERSON, J ;
GOLD, J .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1994, 47 (11) :1245-1251
[6]   Appropriateness of outpatient antibiotic prescribing among privately insured US patients: ICD-10-CM based cross sectional study [J].
Chua, Kao-Ping ;
Fischer, Michael A. ;
Linder, Jeffrey A. .
BMJ-BRITISH MEDICAL JOURNAL, 2019, 364
[7]  
Fronstin P, 2020, EBRI Issue Brief, V498, P1
[8]   Economic Burden of HR+/HER2-Metastatic Breast Cancer Among Adult Premenopausal Women [J].
Gauthier, Genevieve ;
Gagnon-Sanschagrin, Patrick ;
Guerin, Annie ;
Burne, Rebecca ;
Small, Tania ;
Niravath, Polly ;
Dalal, Anand A. .
ADVANCES IN THERAPY, 2018, 35 (04) :503-514
[9]   Breast Cancer Statistics, 2022 [J].
Giaquinto, Angela N. ;
Sung, Hyuna ;
Miller, Kimberly D. ;
Kramer, Joan L. ;
Newman, Lisa A. ;
Minihan, Adair ;
Jemal, Ahmedin ;
Siegel, Rebecca L. .
CA-A CANCER JOURNAL FOR CLINICIANS, 2022, 72 (06) :524-541
[10]   Projecting the Prevalence and Costs of Metastatic Breast Cancer From 2015 through 2030 [J].
Gogate, Anagha ;
Wheeler, Stephanie B. ;
Reeder-Hayes, Katherine E. ;
Ekwueme, Donatus U. ;
Fairley, Temeika L. ;
Drier, Sarah ;
Trogdon, Justin G. .
JNCI CANCER SPECTRUM, 2021, 5 (04)