Healthcare resource utilization and costs associated with patients prescribed afatinib or erlotinib as first-line therapy for EGFR mutation-positive NSCLC in the United States

Abstract

Aims: To assess healthcare resource utilization (HCRU) and costs in patients with non-small cell lung cancer treated with the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors afatinib or erlotinib as first-line treatment. Materials and methods: This retrospective analysis used data from three large administrative claims databases in the US: Truven MarketScan, IMS PharMetrics Plus, and Optum Clinformatics Data Mart. Patients with diagnosis codes of lung cancer treated with afatinib or erlotinib were included in the sample. Treatment cohorts were matched on baseline characteristics using propensity scores to account for potential selection bias. HCRU and healthcare costs were compared between the matched afatinib and erlotinib cohorts. Results: In total, 3,152 patients met the study inclusion criteria; propensity score matching of the afatinib and erlotinib patients yielded 525 matched pairs with well-balanced baseline characteristics. The afatinib cohort had significantly fewer patients with !1 inpatient visits (40.4% vs 52.2%, p ¼ 0.0001) and outpatient emergency room (ER) visits (45.7% vs 54.1%, p ¼ 0.0066). Per patient per month (PPPM) visits were significantly different between afatinib compared to erlotinib for inpatient visits (0.1 vs 0.2, p ¼ 0.0152), other outpatient visits PPPM (2.6 vs 3.0, p ¼ 0.022) and outpatient office visits (2.0 vs 1.7, p ¼ 0.0059

Healthcare Resource Utilization and Costs in Patients with EGFR-Mutated Advanced Non-Small Cell Lung Cancer Receiving First-Line Treatment in the United States: An Insurance Claims-Based Descriptive Analysis

“…While there have been studies evaluating the healthcare costs [ 15 – 17 ] and cost effectiveness [ 18 , 19 ] of previous generation TKIs such as erlotinib and afatinib, research remains limited on the magnitude of real-world total costs of care associated with osimertinib and chemotherapy as 1L therapies. This may be due to the limited time osimertinib has been approved for 1L treatment of metastatic NSCLC (since 2018) [ 8 ], the specific population studied (advanced EGFRm NSCLC), and the difficulty associated with combining cost information with mutation data (without relying on proxies) using real-world data sources.…”