Dataset Information

Cost trends of Metastatic Renal Cell Carcinoma Therapy: the impact of oral anticancer agents and immunotherapy.

ABSTRACT:

Background

Immunotherapy (IO) and oral anticancer agents (OAA) have improved outcomes for metastatic renal cell carcinoma (mRCC) but there is a need to understand real-world costs from the perspective of payers and patients.

Methods

We used retrospective fee-for-service Medicare 100% claims data to study patients diagnosed with mRCC in 2015-2019. We identified initial treatment type and costs (the year after diagnosis) and analyzed differences in monthly and 12-month costs over time and between OAA, IO, and combination groups and the association between OOP costs and adherence.

Results

We identified 15,407 patients with mRCC (61% male; 85% non-Hispanic white). 6,196 received OAA, IO or combination OAA/IO as initial treatment. OAA use decreased (from 31% to 11%) with a simultaneous rise in patients receiving IO (3% to 26%) or combination IO/OAA therapy (1% to 11%). Medicare payments for all patients with mRCC increased by 41%, from $60,320 (95% CI: 58,260-62,380) in 2015 to $85,130 (95% CI: 82,630-87,630) in 2019. Payments increased in patients who received OAA, IO or combination OAA/IO but were stable in those with other/no treatment. Initial higher OOP responsibility ($200-$1000) was associated with 13% decrease in percent days covered in patients receiving OAA in the first 90 days of treatment, compared to those whose OOP responsibility was <$200.

Conclusion

From 2015-2019, costs for Medicare patients with mRCC rose substantially due to more patients receiving IO or IO/OAA combined therapy and increases in costs among those receiving those therapies. Increased OOP costs was associated with decreased adherence.

SUBMITTER: Forman R

PROVIDER: S-EPMC11376369 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

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Publications

Cost trends of metastatic renal cell carcinoma therapy: the impact of oral anticancer agents and immunotherapy.

Forman Rebecca R Long Jessica B JB Westvold Sarah J SJ Agnish Khushi K Mcmanus Hannah D HD Leapman Michael S MS Hurwitz Michael E ME Spees Lisa P LP Wheeler Stephanie B SB Gross Cary P CP Dinan Michaela A MA

JNCI cancer spectrum 20240901 5

<h4>Background</h4>Immunotherapy (IO) and oral anticancer agents (OAA) have improved outcomes for metastatic renal cell carcinoma (mRCC), but there is a need to understand real-world costs from the perspective of payers and patients.<h4>Methods</h4>We used retrospective fee-for-service Medicare 100% claims data to study patients diagnosed with mRCC in 2015-2019. We identified initial treatment type and costs (the year after diagnosis) and analyzed differences in monthly and 12-month costs over t ...[more]

PMID: 39133171

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