TY - JOUR
T1 - Real-World Analysis of Treatment Patterns, Healthcare Utilization, Costs, and Mortality Among People with Biliary Tract Cancers in the USA
AU - Healey, Marcus J.
AU - Seal, Brian
AU - Princic, Nicole
AU - Black, Danae
AU - Malangone-Monaco, Elisabetta
AU - Azad, Nilofer S.
AU - Smoot, Rory L.
N1 - Funding Information:
This study was funded by AstraZeneca Pharmaceuticals. The study sponsor (AstraZeneca Pharmaceuticals) is funding the journal’s Rapid Service Fee. Medical writing and editorial assistance were performed by Merative (previously IBM Watson Health) and was funded by the study sponsor (AstraZeneca Pharmaceuticals). Programming services were provided David Diakun of Merative (previously IBM Watson Health). The study conception and design were conducted by Nilofer Azad, Elisabetta Malangone-Monaco, Marcus Healey, Brian Seal, and Rory Smoot. Material preparation, data collection and analysis were performed by Danae Black, Elisabetta Malangone-Monaco, and Nicole Princic. The first draft of the manuscript was written by Danae Black and Nicole Princic and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. This research was presented in part at the 2022 Academy of Managed Care Pharmacy Nexus conference in National Harbor, Maryland on October 11–14, 2022. Marcus Healey is employed by AstraZeneca Pharmaceuticals; Brian Seal was employed by AstraZeneca Pharmaceuticals at the time the study was conducted. Elisabetta Malangone-Monaco, Nicole Princic, and Danae Black are employed by Merative (previously IBM Watson Health) which received funding from AstraZeneca Pharmaceuticals to conduct this study. Rory Smoot and Nilofer Azad are paid consultants of AstraZeneca Pharmaceuticals. Danae Black is also affiliated with the University of Washington. All database records are statistically de-identified and certified to be fully compliant with US patient confidentiality requirements set forth in the Health Insurance Portability and Accountability Act of 1996. Additionally, the NDI database from the National Center for Health Statistics was linked to approximately 80% of selected people from the MarketScan databases. IRB waiver of authorization approval was obtained from WCG IRB (IRB study #: 1320660; IRB protocol #: 20215641) on October 27, 2021. The data that support the findings of this study are available from Merative (previously IBM Watson Health). Restrictions apply to the availability of these data, which were used under license for this study.
Funding Information:
This study was funded by AstraZeneca Pharmaceuticals. The study sponsor (AstraZeneca Pharmaceuticals) is funding the journal’s Rapid Service Fee.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature.
PY - 2022/12
Y1 - 2022/12
N2 - Introduction: People with advanced biliary tract cancers (BTCs) have a 5-year survival of approximately 2% in the USA. Most cases are inoperable or require systemic treatment following surgery. This study adds to current literature by describing treatment patterns, healthcare resource utilization (HCRU), costs, and mortality among people with BTCs. Methods: Adults diagnosed with BTCs were identified in the Merative MarketScan administrative claims databases from 1 January 2016 to 30 June 2020. Descriptive analysis was used to measure treatment patterns (i.e., regimen types, therapy duration) during three lines of therapy (LOT). All-cause and disease-related HCRU and costs were measured per-patient-per-month (PPPM) during the entire follow-up and in each LOT. Mortality was reported among the subset linked to the National Death Index (NDI). Results: There were 2648 eligible people with BTCs [mean age 64.0 (standard deviation [SD] 12.4) years, 51.5% female, average follow-up 11.9 (SD 11.1) months]. Treatment was received by 56.3% (n = 1490), and 20.9% (n = 5534) and 7.1% (n = 187) moved on to a second and third LOT, respectively. The average treatment duration decreased across LOTs, from 3.8 (SD 3.1) months in LOT1 to 2.6 (SD 2.4) months in LOT3. Gemcitabine + cisplatin was the most common regimen in LOT1 (44.6%). Total all-cause mean healthcare costs PPPM increased after LOT1 (mean $21,517, $29,721, and $28,557, for LOT1, LOT2, and LOT3, respectively) and the majority (71.2%) were related to BTCs. Of people with BTCs linked to the NDI (n = 2168), 66.1% died and average time to death was 11.3 (SD 11.2) months. Conclusions: These findings, showing a high rate of mortality, a decrease in treatment duration, and an increase in costs as people progress after LOT1, add recent data to current literature highlighting the unmet need for more effective treatment options for people with BTCs.
AB - Introduction: People with advanced biliary tract cancers (BTCs) have a 5-year survival of approximately 2% in the USA. Most cases are inoperable or require systemic treatment following surgery. This study adds to current literature by describing treatment patterns, healthcare resource utilization (HCRU), costs, and mortality among people with BTCs. Methods: Adults diagnosed with BTCs were identified in the Merative MarketScan administrative claims databases from 1 January 2016 to 30 June 2020. Descriptive analysis was used to measure treatment patterns (i.e., regimen types, therapy duration) during three lines of therapy (LOT). All-cause and disease-related HCRU and costs were measured per-patient-per-month (PPPM) during the entire follow-up and in each LOT. Mortality was reported among the subset linked to the National Death Index (NDI). Results: There were 2648 eligible people with BTCs [mean age 64.0 (standard deviation [SD] 12.4) years, 51.5% female, average follow-up 11.9 (SD 11.1) months]. Treatment was received by 56.3% (n = 1490), and 20.9% (n = 5534) and 7.1% (n = 187) moved on to a second and third LOT, respectively. The average treatment duration decreased across LOTs, from 3.8 (SD 3.1) months in LOT1 to 2.6 (SD 2.4) months in LOT3. Gemcitabine + cisplatin was the most common regimen in LOT1 (44.6%). Total all-cause mean healthcare costs PPPM increased after LOT1 (mean $21,517, $29,721, and $28,557, for LOT1, LOT2, and LOT3, respectively) and the majority (71.2%) were related to BTCs. Of people with BTCs linked to the NDI (n = 2168), 66.1% died and average time to death was 11.3 (SD 11.2) months. Conclusions: These findings, showing a high rate of mortality, a decrease in treatment duration, and an increase in costs as people progress after LOT1, add recent data to current literature highlighting the unmet need for more effective treatment options for people with BTCs.
KW - Biliary tract cancer
KW - Cost of illness
KW - Healthcare
KW - USA
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UR - http://www.scopus.com/inward/citedby.url?scp=85140068307&partnerID=8YFLogxK
U2 - 10.1007/s12325-022-02342-8
DO - 10.1007/s12325-022-02342-8
M3 - Article
C2 - 36241962
AN - SCOPUS:85140068307
SN - 0741-238X
VL - 39
SP - 5530
EP - 5545
JO - Advances in Therapy
JF - Advances in Therapy
IS - 12
ER -