PCN76 Evaluating Trends In Direct Healthcare Costs In The Last Year Of Life Among Patients With Lung Cancer In Germany

BackgroundGrowing evidence indicates that prolonged sedentary behaviour increases the risk of several chronic health conditions and all-cause mortality. Sedentary behaviour is prevalent among adults in the UK. Quantifying the costs associated with sedentary behaviour is an important step in the development of public health policy.MethodsNational Health Service (NHS) costs associated with prolonged sedentary behaviour (≥6 hours/day) were estimated over a 1-year period in 2016–2017 costs. We calculated a population attributable fraction (PAF) for five health outcomes (type 2 diabetes, cardiovascular disease [CVD], colon cancer, endometrial cancer and lung cancer). Adjustments were made for potential double-counting due to comorbidities. We also calculated the avoidable deaths due to prolonged sedentary behaviour using the PAF for all-cause mortality.ResultsThe total NHS costs attributable to prolonged sedentary behaviour in the UK in 2016–2017 were £0.8 billion, which included expenditure on CVD (£424 million), type 2 diabetes (£281 million), colon cancer (£30 million), lung cancer (£19 million) and endometrial cancer (£7 million). After adjustment for potential double-counting, the estimated total was £0.7 billion. If prolonged sedentary behaviour was eliminated, 69 276 UK deaths might have been avoided in 2016.ConclusionsIn this conservative estimate of direct healthcare costs, prolonged sedentary behaviour causes a considerable burden to the NHS in the UK. This estimate may be used by decision makers when prioritising healthcare resources and investing in preventative public health programmes.

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731 Costs of care for first-line (1L) treatment of advanced non-small cell lung cancer (aNSCLC): a real-world claims analysis

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-sitc2020.0731 ◽

2020 ◽

Vol 8 (Suppl 3) ◽

pp. A775-A775

Author(s):

Jonathan Kish ◽

Dhruv Chopra ◽

Djibril Liassou ◽

Solomon Lubinga ◽

John Hartman ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Healthcare Costs ◽

Healthcare Resource Utilization ◽

Small Cell ◽

Small Cell Lung ◽

Icd 10 ◽

Direct Healthcare Costs ◽

Comorbidity Index

BackgroundRecent advances in therapy have created numerous options for the 1L treatment of aNSCLC. This study describes the total direct healthcare costs for patients treated with immunotherapy monotherapy (IO), chemotherapy (CT), or immunotherapy plus chemotherapy (IO+CT) in the 1L setting.MethodsThe Ability Patient Complete claims database was used to identify US patients aged ≥ 18 years diagnosed with aNSCLC (ICD-9: 162.*; ICD-10: C34.*) initiating 1L treatment with IO, CT, or IO+CT between January 2015 and May 2019. Patients were required to have at least 6 months of continuous enrollment prior to initiation of 1L treatment, ≥ 1 inpatient or 2 outpatient claims for lung cancer, and a claim within 45 days for a secondary metastatic site. Patients with another malignant primary cancer, who participated in a clinical trial, or who received treatments consistent with small cell lung cancer or a systemic therapy not used for lung cancer were excluded. Costs were calculated on a per-patient per month (PPPM) basis from initiation of 1L treatment until discontinuation or end of study period and expressed in 2019 US dollars. A standardized cost approach was applied, with average wholesale prices for antineoplastic and other drug costs and CMS fee schedules for outpatient visits, inpatient stays, ED visits, and other medical costs (e.g. all other outpatient medical services including infusions of growth factors, radiographic studies, blood draws, etc.). All antineoplastic costs were considered individually.Results8,154 patients were included in the cohort: 1,319 received IO, 5,315 CT, and 1,520 IO+CT. By cohort, mean age was 65 (IO), 63 (CT), and 62 (IO+CT) years while mean Charlson Comorbidity Index was 2.12, 2.11, and 1.83, respectively. Key results by healthcare resource utilization category are provided in the table below (table 1).Abstract 731 Table 1Mean PPPM Costs of 1L aNSCLC TreatmentsConclusionsThe total PPPM healthcare costs of patients receiving chemotherapy (CT or IO+CT) are higher than those only receiving IO monotherapy. These differences are driven by higher outpatient visit, other medical, and pharmacy costs. IO-containing regimens have higher antineoplastic costs than CT, but options with no or limited CT may be able to offset these costs through a reduction in other medical expenses.

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Cost of Venous Thromboembolic Disease in Patients with Lung Cancer: Costecat Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020394 ◽

2021 ◽

Vol 18 (2) ◽

pp. 394

Author(s):

Ana Rosa Rubio-Salvador ◽

Vicente Escudero-Vilaplana ◽

José Antonio Marcos Rodríguez ◽

Irene Mangues-Bafalluy ◽

Beatriz Bernardez ◽

...

Keyword(s):

Lung Cancer ◽

Venous Thromboembolism ◽

Healthcare Costs ◽

Hospital Admissions ◽

Health Resources ◽

Pharmacoeconomic Study ◽

First Episode ◽

Venous Thromboembolic ◽

Direct Healthcare Costs ◽

The Cost

Background: Patients with lung cancer (LC) are at significantly higher risk of developing venous thromboembolism (VTE), which may lead to increased use of health resources and the cost of management. The main aim of the study was to determine the cost of the management of VTE events in patients with LC treated with Low Molecular Weight Heparins (LMWH) in Spain. Methods: Costecat was an, observational, ambispective pharmacoeconomic study. Patients with LC, with a first episode of VTE (symptomatic or incidental) in treatment with LMWH, were recruited from six third-level hospitals and followed up for six months. Sociodemographic, clinical and resource use variables of VTE-related implications and its treatment were collected. Direct healthcare costs and direct non-healthcare costs were recorded. Data collection was documented in an electronic case report. Unit costs were obtained from national databases. Costs (€2018) were estimated from the healthcare perspective. Statistical analysis was performed using the statistical program R 3.4.3 version (30 November 2017). Results: Forty-seven patients were included. Mean age was 65.4 years, 66.0% were male. The percentage of patients with LC who had metastatic disease was 78.7%. Twenty-three patients (48.9%) needed hospital admissions due to thromboembolic episode. Total average cost of patients with cancer associated VTE (CAT) was €109,696.6 per patient/semester. The hospitalizations represent 65.8% of total costs (7207.3 € SD 13,996.9 €), followed by LMWH therapy which represents 18.6% (2033.8 € SD:630.5 €). Conclusions: Venous thromboembolism episodes induce an economic impact on patients and healthcare systems. Direct healthcare costs are the major burden of the total cost, in which hospitalizations are the main drivers of cost.

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Frailty Phenotype and Healthcare Costs in Women in Late Life: The SOF study

Innovation in Aging ◽

10.1093/geroni/igaa057.2814 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 778-778

Author(s):

Lisa Langsetmo ◽

Allyson Kats ◽

John Schousboe ◽

Tien Vo ◽

Brent Taylor ◽

...

Keyword(s):

Healthcare Costs ◽

Functional Limitations ◽

Late Life ◽

Cost Ratio ◽

Deficit Accumulation ◽

Frailty Phenotype ◽

Medicare Claims ◽

Accumulation Index ◽

Direct Healthcare Costs ◽

Frailty Indicator

Abstract We used data from 1324 women (mean age 83) at the 2002-2004 exam linked with their Medicare claims to determine the association of the frailty phenotype with healthcare costs. The frailty phenotype was categorized as robust, pre-frail or frail. Multimorbidity and a frailty indicator (approximating the deficit accumulation index) were derived from claims. Functional limitations were assessed by asking about difficulty performing IADL. Total direct healthcare costs were ascertained during 36 months following the exam. Compared with robust, pre-frailty and frailty were associated with higher costs after accounting for demographics, multimorbidity, functional limitations and the frailty indicator (cost ratio 1.37 [1.10-1.71] among pre-frail and 1.63 [1.28-2.08] among frail). Discrimination of high-cost (top decile) women was improved by adding the phenotype and functional limitations to a model containing demographics and the claims-based measures. Findings suggest that assessment of the phenotype may improve identification of individuals at higher risk of costly care.

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1228 Real-world direct healthcare costs for metastatic colorectal cancer patients treated with cetuximab vs. bevacizumab containing regimen in first-line, or sequentially in first- and second-line, from a US private payer perspective

European Journal of Cancer ◽

10.1016/s0959-8049(16)30532-9 ◽

2015 ◽

Vol 51 ◽

pp. S182

Author(s):

S. Johnston ◽

K. Wilson ◽

E. Riehle ◽

H. Varker ◽

P. Juneau ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Patients ◽

Real World ◽

Healthcare Costs ◽

Second Line ◽

First Line ◽

Payer Perspective ◽

Direct Healthcare Costs ◽

Colorectal Cancer Patients ◽

Private Payer

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MO545INSIDE ANEMIA OF CKD: ESTIMATING THE IMPACT OF POLICY INTERVENTIONS ON ANAEMIA OF CKD IN THE USA BY MICROSIMULATION MODELLING

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab085.008 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Lise Retat ◽

Laura Webber ◽

Juan Jose Garcia Sanchez ◽

Claudia Cabrera ◽

Susan Grandy ◽

...

Keyword(s):

Healthcare Costs ◽

Severe Anaemia ◽

Service Planning ◽

Microsimulation Model ◽

Model Framework ◽

The Us ◽

The Usa ◽

Direct Healthcare Costs ◽

The Impact ◽

Intervention Scenario

Abstract Background and Aims Anaemia is a common complication in patients with chronic kidney disease (CKD) and is associated with increased mortality, cardiovascular complications, reduced quality of life and increased use of healthcare resources. Mathematical modelling based on robust epidemiological and clinical data is a useful approach for predicting the future burden of disease and the impact of different intervention scenarios; this is important for health service planning. This analysis uses a microsimulation model, Inside ANEMIA of CKD, to predict the effects of a hypothetical intervention scenario that reduces the prevalence of anaemia of CKD on related healthcare costs in the USA from 2020 to 2025. Method A virtual cohort representing the US population was created within the Inside ANEMIA of CKD microsimulation model framework using demographics and epidemiological data drawn from the US Census Bureau, the Centers for Disease Control and Prevention, and the National Health and Nutrition Examination Survey. In the cohort, virtual individuals were ascribed an age–sex-stratified CKD status (defined by estimated glomerular filtration rate and albuminuria levels, as per international guidelines) and anaemia status (defined by haemoglobin level as mild, moderate or severe, as per WHO criteria) based on US prevalence data. Key comorbidities (type 2 diabetes, heart failure and hypertension) were also assigned, reflecting US-specific population statistics. Healthcare costs related to CKD and anaemia of CKD were taken from the published literature. The study modelled the effects on healthcare costs of a hypothetical intervention scenario in which the prevalence of moderate and severe anaemia is reduced by 20% per year from 2020 to 2025 compared with no intervention (baseline). In each scenario (i.e. intervention or baseline), the modelling analysis estimated healthcare costs related to CKD and anaemia (including inpatient, outpatient, pharmacy costs) for patients with moderate or severe anaemia of CKD. The model did not adjust for the potential costs of the intervention. Results Preliminary results predict that, with the hypothetical intervention, there could be 1.40 million fewer patients with moderate or severe anaemia of CKD in the USA in 2025 compared with no intervention (1.45 million versus 2.85 million). This represents a 49% reduction in cases of moderate or severe anaemia of CKD in 2025 with the intervention versus no intervention. The intervention is projected to lead to a reduction of approximately US$18 billion in annual direct healthcare costs in 2025 for patients with moderate or severe anaemia of CKD compared with no intervention (US$26 billion versus US$44 billion). Conclusion The Inside ANEMIA of CKD microsimulation model predicts that a hypothetical intervention which reduces the prevalence of moderate and severe anaemia of CKD would reduce direct healthcare costs. This suggests that interventions effective at reducing the prevalence of anaemia of CKD would help to reduce the economic burden on healthcare services.

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PCN80 REAL-WORLD HEALTHCARE COSTS IN PATIENTS WITH METASTATIC NON SMALL CELL LUNG CANCER IN ITALY

Value in Health ◽

10.1016/j.jval.2019.09.277 ◽

2019 ◽

Vol 22 ◽

pp. S451

Author(s):

V. Danesi ◽

I. Massa ◽

M. Altini ◽

W. Balzi ◽

N. Gentili ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Real World ◽

Healthcare Costs ◽

Small Cell ◽

Small Cell Lung

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Direct costs of overdiagnosed asthma: a longitudinal, population-based cohort study in British Columbia, Canada

BMJ Open ◽

10.1136/bmjopen-2019-031306 ◽

2019 ◽

Vol 9 (11) ◽

pp. e031306 ◽

Cited By ~ 1

Author(s):

Bryan Ng ◽

Mohsen Sadatsafavi ◽

Abdollah Safari ◽

J Mark FitzGerald ◽

Kate M Johnson

Keyword(s):

Cohort Study ◽

Resource Use ◽

Healthcare Costs ◽

Challenge Test ◽

Medication Use ◽

Population Based ◽

Methacholine Challenge ◽

Physician Visits ◽

Direct Healthcare Costs ◽

Physician Diagnosis

ObjectivesA current diagnosis of asthma cannot be objectively confirmed in many patients with physician-diagnosed asthma. Estimates of resource use in overdiagnosed cases of asthma are necessary to measure the burden of overdiagnosis and to evaluate strategies to reduce this burden. We assessed differences in asthma-related healthcare resource use between patients with a confirmed asthma diagnosis and those with asthma ruled out.DesignPopulation-based, prospective cohort study.SettingParticipants were recruited through random-digit dialling of both landlines and mobile phones in the province of British Columbia, Canada.ParticipantsWe included 345 individuals ≥12 years of age with a self-reported physician diagnosis of asthma. The diagnosis of asthma was reassessed at the end of 12 months of follow-up using a structured algorithm, which included a bronchodilator reversibility test, methacholine challenge test, and if necessary medication tapering and a second methacholine challenge test.Primary and secondary outcome measuresSelf-reported annual asthma-related direct healthcare costs (2017 Canadian dollars), outpatient physician visits and medication use from the perspective of the Canadian healthcare system.ResultsAsthma was ruled out in 86 (24.9%) participants. The average annual asthma-related direct healthcare costs for participants with confirmed asthma were $C497.9 (SD $C677.9) and for participants with asthma ruled out, $C307.7 (SD $C424.1). In the adjusted analyses, a confirmed diagnosis was associated with higher direct healthcare costs (relative ratio (RR)=1.60, 95% CI 1.14 to 2.22), increased rate of specialist visits (RR=2.41, 95% CI 1.05 to 5.40) and reliever medication use (RR=1.62, 95% CI 1.09 to 2.35), but not primary care physician visits (p=0.10) or controller medication use (p=0.11).ConclusionsA quarter of individuals with a physician diagnosis of asthma did not have asthma after objective re-evaluation. These participants still consumed a significant amount of asthma-related healthcare resources. The population-level economic burden of asthma overdiagnosis could be substantial.

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