US Oncology Health Economics and Outcomes Research, AstraZeneca, 1 Medimmune Way, Gaithersburg, MD, 20878, USA.
Icahn School of Medicine at Mount Sinai, Blavatnik Family Women's Health Research Institute, New York, NY, USA.
Adv Ther. 2022 Jun;39(6):2544-2561. doi: 10.1007/s12325-022-02086-5. Epub 2022 Apr 1.
Ovarian cancer (OC) is one of the leading causes of cancer mortality among women in the United States. With the approval of first-line maintenance therapies, patients with OC experienced prolonged first-line progression-free survival. While the literature addresses some costs associated with OC, further research is needed on the costs of progression that are potentially deferred or prevented by early maintenance. The objective of this study was to capture the health care resource utilization and costs of patients with advanced OC who never received poly(ADP ribose) polymerase (PARP) inhibitor maintenance.
We conducted a descriptive retrospective analysis of treatment patterns and the consequences of progression through several lines of therapy (LOTs) in patients with OC, using claims from commercial and Medicare Advantage health plan members in the United States from the Optum Research Database between January 1, 2010, and April 30, 2019. Patients were required to have an index OC diagnosis (≥ 2 non-diagnostic claims). We examined up to 4 LOTs and the time between treatments.
A total of 5498 women met the eligibility criteria. As the number of LOTs increased, the median duration of each line decreased from 137 days in LOT1 to 94 days in LOT4, and the time between lines also decreased from 245 to 0 days. Ambulatory care visits were a major driver of health care resource utilization, with a median of about 6 monthly visits during active treatment. The mean total monthly health care costs for patients with at least 2 LOTs were US$8588 (SD: $8533) before LOT2 and increased to $15,358 (SD: $21,460) during or after LOT2.
Prolonging progression-free survival after first-line treatment in patients with OC may provide the opportunity to delay or prevent later treatment, the financial toxicity felt by patients, and the economic burden to the health care system associated with progression.
卵巢癌（OC）是美国女性癌症死亡的主要原因之一。随着一线维持治疗的批准，OC 患者的一线无进展生存期延长。尽管文献中提到了一些与 OC 相关的成本，但需要进一步研究通过早期维持治疗来推迟或预防进展所带来的潜在成本。本研究旨在描述从未接受过聚（ADP 核糖）聚合酶（PARP）抑制剂维持治疗的晚期 OC 患者的医疗资源利用和成本情况。
我们使用美国 Optum Research Database 中来自商业和 Medicare Advantage 健康计划成员的索赔数据，对 2010 年 1 月 1 日至 2019 年 4 月 30 日期间患有 OC 的患者的治疗模式和通过多个治疗线（LOT）进展的后果进行了描述性回顾性分析。患者需要有 OC 的索引诊断（≥2 次非诊断性索赔）。我们检查了最多 4 个 LOT 以及治疗之间的时间。
共有 5498 名女性符合入选标准。随着 LOT 数量的增加，每一线的中位持续时间从 LOT1 的 137 天减少到 LOT4 的 94 天，线与线之间的时间也从 245 天减少到 0 天。门诊就诊是医疗资源利用的主要驱动因素，在积极治疗期间每月中位数约有 6 次就诊。至少接受 2 个 LOT 的患者每月的平均总医疗保健费用在 LOT2 之前为 8588 美元（SD：8533 美元），在 LOT2 期间或之后增加到 15358 美元（SD：21460 美元）。
在 OC 患者中，延长一线治疗后的无进展生存期可能为延迟或预防后期治疗、患者所感受到的财务毒性以及与进展相关的医疗保健系统的经济负担提供机会。
