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美国转移性非小细胞肺癌一线治疗的真实世界治疗模式、医疗资源利用及医疗成本

Real-World Treatment Patterns, Healthcare Resource Utilization, and Healthcare Costs in the First-Line Treatment of Metastatic Non-Small Cell Lung Cancer in the US.

作者信息

Chopra Divyan, Waterhouse David M, Sultan Ihtisham, Stollenwerk Björn

机构信息

Amgen, Thousand Oaks, CA 91320, USA.

OHC (Oncology Hematology Care), Cincinnati, OH 45242, USA.

出版信息

Curr Oncol. 2025 Mar 5;32(3):151. doi: 10.3390/curroncol32030151.

Abstract

This study characterizes real-world treatment patterns and economic and healthcare resource utilization (HCRU) burden associated with first-line (1L) treatment of metastatic non-small cell lung cancer (NSCLC) without actionable alterations in the United States. This retrospective observational study used Optum Clinformatics data. A total of 15,659 patients with metastatic NSCLC who started 1L treatment between January 2020 and March 2023 were included (52% male; mean age at the start of 1L treatment 71.7 years; 86% Medicare Advantage). The most frequent 1L regimens were immune checkpoint inhibitor (ICI) + platinum-based chemotherapy (PBCT) (47%), PBCT only (26%), and ICI only (20%). The median 1L treatment duration was 4.2 months (range 2.7-6.5) and was shorter with chemotherapy-only regimens. Outpatient visits accounted for the majority of HCRU (mean 6.6 visits per patient per month [PPPM]). Outpatient, inpatient, and emergency department visits were highest for chemotherapy-only regimens. Mean total (all-cause) healthcare costs were $32,215 PPPM and were highest for ICI + chemotherapy ($34,741-38,454 PPPM). Inpatient costs PPPM were highest for PBCT ($4725) and ICI + non-PBCT ($4648). First-line treatment of metastatic NSCLC without actionable alterations imposes a notable HCRU and cost burden, underscoring the need for better treatment options to improve outcomes and reduce economic impact.

摘要

本研究描述了美国转移性非小细胞肺癌(NSCLC)一线(1L)治疗的真实世界治疗模式以及与之相关的经济和医疗资源利用(HCRU)负担,这些患者不存在可操作的改变。这项回顾性观察研究使用了Optum临床信息学数据。纳入了2020年1月至2023年3月期间开始1L治疗的15659例转移性NSCLC患者(52%为男性;1L治疗开始时的平均年龄为71.7岁;86%为医疗保险优势计划参保者)。最常见的1L治疗方案是免疫检查点抑制剂(ICI)+铂类化疗(PBCT)(47%)、单纯PBCT(26%)和单纯ICI(20%)。1L治疗的中位持续时间为4.2个月(范围2.7 - 6.5个月),单纯化疗方案的治疗持续时间较短。门诊就诊占HCRU的大部分(平均每位患者每月6.6次就诊[PPPM])。单纯化疗方案的门诊、住院和急诊科就诊次数最多。平均总(全因)医疗费用为32215美元/PPPM,ICI +化疗方案的费用最高(34741 - 38454美元/PPPM)。PBCT方案的住院费用/PPPM最高(4725美元),ICI +非PBCT方案的住院费用/PPPM为4648美元。对于不存在可操作改变的转移性NSCLC患者,一线治疗带来了显著的HCRU和成本负担,凸显了需要更好的治疗方案以改善治疗效果并降低经济影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9272/11940980/6e9203f0dd8b/curroncol-32-00151-g001.jpg

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