Chopra Divyan, Waterhouse David M, Sultan Ihtisham, Stollenwerk Björn
Amgen, Thousand Oaks, CA 91320, USA.
OHC (Oncology Hematology Care), Cincinnati, OH 45242, USA.
Curr Oncol. 2025 Mar 5;32(3):151. doi: 10.3390/curroncol32030151.
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.
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。