PMID- 33576296
OWN - NLM
STAT- MEDLINE
DCOM- 20210309
LR  - 20220420
IS  - 1941-837X (Electronic)
IS  - 1369-6998 (Linking)
VI  - 24
IP  - 1
DP  - 2021 Jan-Dec
TI  - Real-world impact of brain metastases on healthcare utilization and costs in 
      patients with non-small cell lung cancer treated with EGFR-TKIs in the US.
PG  - 328-338
LID - 10.1080/13696998.2021.1885418 [doi]
AB  - BACKGROUND: Non-small cell lung cancer (NSCLC) with brain metastases (BM) is 
      difficult to treat and associated with poor survival. This study assessed the 
      impact of BM on healthcare-related utilization and costs (HRUC) among patients 
      receiving epidermal growth factor receptor tyrosine kinase inhibitors 
      (EGFR-TKIs). PATIENTS AND METHODS: Adults newly-diagnosed with metastatic NSCLC, 
      initiating first-/second-generation EGFR-TKI treatment, with BM or no BM (NBM), 
      were identified retrospectively from IBM MarketScan healthcare claims databases 
      (2013-2017). HRUC were measured during the variable-length follow-up period. 
      Generalized linear models assessed the impact of BM on total healthcare costs, 
      standardized to 2017 US$. RESULTS: Overall, 222 BM and 280 NBM patients were 
      included, with a mean duration of follow-up of 14 months. Adjusted NSCLC-related 
      and all-cause costs over average follow-up were 1.2 times higher among BM 
      patients (Delta$5,640 and Delta$6,366, respectively; p <0.05); differences were driven 
      primarily by radiation treatment and radiology. More than two times more BM than 
      NBM patients received NSCLC-related radiation treatment, in both inpatient (15.3% 
      vs 6.8%; p <0.05) and outpatient settings (87.8% vs 37.5%; p <0.05). Per-patient 
      per-month (PPPM) radiation costs were also higher among BM patients, both 
      inpatient ($796 vs $464, p =0.172) and outpatient ($2,443 vs $747, p <0.05). 
      All-cause PPPM radiology visits (2.0 vs 1.3) and associated costs ($3,824 vs 
      $1,621) were higher among BM patients (both p <0.05). CONCLUSION: NSCLC-related 
      HRUC, especially those attributable to radiation treatment, were higher among 
      patients with BM. Future research should compare the potential for CNS-active 
      EGFR-TKIs vs first-/second-generation EGFR-TKIs combined with radiotherapy to 
      reduce HRUC.
FAU - Kong, Amanda M
AU  - Kong AM
AD  - IBM Watson Health, Cambridge, MA, USA.
FAU - Pavilack, Melissa
AU  - Pavilack M
AD  - AstraZeneca, Gaithersburg, MD, USA.
FAU - Huo, Hairong
AU  - Huo H
AD  - AstraZeneca, Gaithersburg, MD, USA.
FAU - Shenolikar, Rahul
AU  - Shenolikar R
AD  - AstraZeneca, Gaithersburg, MD, USA.
FAU - Moynihan, Meghan
AU  - Moynihan M
AD  - IBM Watson Health, Cambridge, MA, USA.
FAU - Marchlewicz, Elizabeth H
AU  - Marchlewicz EH
AD  - IBM Watson Health, Cambridge, MA, USA.
FAU - Chebili-Larson, Christina
AU  - Chebili-Larson C
AD  - IBM Watson Health, Cambridge, MA, USA.
FAU - Min, Stella
AU  - Min S
AD  - IBM Watson Health, Cambridge, MA, USA.
FAU - Subramaniam, Deepa S
AU  - Subramaniam DS
AD  - AstraZeneca, Gaithersburg, MD, USA.
AD  - Georgetown University, Washington DC, USA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Med Econ
JT  - Journal of medical economics
JID - 9892255
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Protein Kinase Inhibitors)
RN  - EC 2.7.10.1 (ErbB Receptors)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Antineoplastic Agents/therapeutic use
MH  - Brain Neoplasms/*economics/*secondary
MH  - Carcinoma, Non-Small-Cell Lung/drug therapy/*pathology
MH  - ErbB Receptors/antagonists & inhibitors
MH  - Health Expenditures/statistics & numerical data
MH  - Health Resources/*economics/*statistics & numerical data
MH  - Humans
MH  - Insurance Claim Review
MH  - Lung Neoplasms/*pathology
MH  - Middle Aged
MH  - Models, Economic
MH  - Protein Kinase Inhibitors/therapeutic use
MH  - Sex Factors
MH  - Socioeconomic Factors
OTO - NOTNLM
OT  - I
OT  - Non-small cell lung cancer
OT  - Z
OT  - brain tumors
OT  - epidermal growth factor receptor
OT  - healthcare costs
EDAT- 2021/02/13 06:00
MHDA- 2021/03/10 06:00
CRDT- 2021/02/12 08:39
PHST- 2021/02/13 06:00 [pubmed]
PHST- 2021/03/10 06:00 [medline]
PHST- 2021/02/12 08:39 [entrez]
AID - 10.1080/13696998.2021.1885418 [doi]
PST - ppublish
SO  - J Med Econ. 2021 Jan-Dec;24(1):328-338. doi: 10.1080/13696998.2021.1885418.