Additional NSCLC Treatments Needed to Reduce Post-Progression Costs

A study presented at AMCP Nexus 2017 found that costs during TKI treatment for Non-small cell lung cancer were similar to costs after progression, due to high hospital utilization.

“Epidermal growth factor receptor tyrosine kinase inhibitors (TKIs) improve outcomes in patients with EGFR mutation-positive, advanced non-small cell lung cancer,” Karen Skinner, MPH, director of HEOR at Vector Oncology, and colleagues wrote. “However, resistance to EGFR TKIs does develop and leads to disease progression. Characterizing cost of care is necessary to understand the economic burden in patients with non-small cell lung cancer receiving EGFR TKIs during initial treatment and following progression.”

In order to determine the cost of care and the factors impacting costs during first- and second-generation treatment with TKIs, and how these costs compare to post-progression care costs, the researchers conducted a retrospective analysis of 10 oncology practices in the United States. They review 364 patients with advanced non-small cell lung cancer who were treated with Tarceva (erlotinib; Genentech) or Gilotrif (afatinib; Boehringer Ingelheim) between 2008 and 2015. They examined Medicare costs during therapy and post-progression.

The researchers found that total mean monthly costs during TKI therapy were $20,106 per patient, made up mostly of hospitalization and cancer therapy costs. Study results showed that post-progression mean monthly costs were $19,274 per patient.

The researchers determined that the similarity between TKI treatment costs and post-progression treatment costs reveal the need for treatments to target disease in the post progression period.

“The cost of care during TKI treatment and following progression appeared to be similar and was largely attributed to hospitalization and anti-cancer therapy,” they wrote.

“Among patients not receiving anti-cancer therapy, hospitalization was the largest cost contributor, highlighting the need for additional effective targeted therapies that could prevent hospitalization after progression on first- or second-generation EGFR TKIs.”

—David Costill

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