A recent analysis by Wade Thomas Iams, MD, Vanderbilt University Medical Center, Nashville, TN, and colleagues analyzed the real-world health care costs for patients with non–small cell lung cancer (NSCLC) given the host immune classifier (HIC) test. These findings were presented at the 2023 ASCO Annual Meeting in Chicago, IL. 

The HIC test is used to evaluate a patient’s prognosis and response to NSCLC treatment, and it categorizes patients into two groups: HIC Hot (HIC-H) and HIC Cold (HIC-C). However, to date there has been no real-world analysis to determine if HIC status is associated with a difference in health care costs for patients. Dr Iams and colleagues evaluated these costs for patients with NSCLC both prior to and after receiving the HIC test.

The researchers used MarketScan Commercial and Medicare Supplemental databases to obtain HIC test results received between January 1, 2016, and June 30, 2021. To be included in the study, patients had to be ≥18 years old; have undergone HIC testing; be enrolled in the MarketScan database continuously for at least 6 months before January 1, 2016 (preindex), and 1 month after June 30, 2021 (postindex); and have one or more nondiagnostic medical claims of lung cancer during the preindex period. The cost of health care was measured per patient per month for the preindex and postindex periods and then compared based on HIC status (HIC-H vs HIC-C). The evaluated costs included inpatient, outpatient, outpatient pharmacy, total medical (inpatient plus outpatient), and total overall (total medical plus outpatient pharmacy).

There were 328 total patients included in the study (HIC-H = 260; HIC-C = 68). Of those, 178 had nonmetastatic lung cancer and 150 had metastatic lung cancer. For the preindex period, HIC-C patients had higher health care costs than HIC-H patients in most of the evaluated categories, including total overall costs ($10,299 vs $9,689; not statistically significant); inpatient costs ($4,032 vs $3,218; not statistically significant) ; and biopsy costs ($1,285 vs $400; P < .05 ), even though fewer HIC-C patients underwent a lung biopsy (41% vs 53%; P = .091). Similarly, HIC-C patients had higher health care costs during the postindex period for total medical costs ($25,255 vs $17,210; P < .05); inpatient costs ($9,903 vs $5,583; not statistically significant); and total overall costs ($26,237 vs $18,652; not statistically significant). 

Based on this analysis, the authors concluded that patients with NSCLC who are categorized as HIC-C experience higher health care costs both before and after receiving the HIC test. “Utilization of the HIC test may help to identify patients who may benefit from additional health system navigation support to mitigate their anticipated increased health care costs,” they wrote. 

Source:

Iams WT, Le K, Princic N, Marlin T. Real-world healthcare costs amongst non-small cell lung cancer (NSCLC) patients tested with a host immune classifier (HIC). Presented at the 2023 ASCO Annual Meeting; June 2-6, 2023; Chicago, IL, and virtual; Abstract e21187.