The study observed significant shifts in the treatment of advanced-stage non-small cell lung cancer (NSCLC), accompanied by only modest gains in survival and total Medicare spending.
Non—small cell lung cancer (NSCLC) has seen significant advances in treatment options over the past decade. According to a new study, significant shifts in the treatment of advanced-stage NSCLC is accompanied by only modest gains in survival and total Medicare spending.
For their study, the authors used the SEER-Medicare data for elderly patients who had a new diagnosis of advanced NSCLC and were subsequently treated between 2000 and 2011. For the duration of their study, the authors noted a marked shift in treatment, with a quick adoption of pemetrexed (39.2%), erlotinib (20.3%), and bevacizumab (18.9%). There was a simultaneous decrease in use of paclitaxel (38.7%), gemcitabine (17.0%), and vinorelbine (5.7%). Overall, duration of treatment increased by an average of 5 days, with patients on bevacizumab, erlotinib, or pemetrexed having the longest treatment on average (146 days, compared with 75 days for those who did not receive these agents).
While carboplatin was the most commonly prescribed agent for advanced NSCLC over that entire study period, the use of pemetrexed, bevacizumab, and erlotinib also increased in popularity.
Acute inpatient spending for this patient cohort decreased from $29,376 to $23,731, a decrease of more than $5000 per patient. Outpatient spending, however, increased from $37,931 to $46,642. For patients who had Medicare Part D prescription coverage, Part D total gross spending increased from $6617 in 2007 to $8177 in 2011—a 24% increase. Total Medicare spending for Part D beneficiaries saw a 9% increase between 2007 and 2011.
Survival, on the other hand, saw a slight increase of just 1.5 months.
The authors conclude that understanding practice patterns for highly prevalent cancers, such as advanced NSCLC, is important to study. “More evidence is needed to weight the benefit of these agents against their costs and the possibility of savings with lower prices and lower inpatient use,” they wrote.
Reference
Bradley CJ, Yabroff KR, Mariotto AB, Zeruto C, Tran Q, Warren JL. Antineoplastic treatment of advanced-stage non—small-cell lung cancer: treatment, survival, and spending (2000 to 2011) [published online January 3, 2017]. J Clin Oncol.
Standard Criteria for Loss of Ambulation Needed in DMD
April 19th 2024A recent study suggests the differences between ambulation definitions for patients with Duchenne muscular dystrophy (DMD) can impact the identification of ambulant vs nonambulant individuals, and standard criteria across settings are needed.
Read More
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
Listen
Government agencies have created an online portal for the public to report potential anticompetitive practices in health care; there are changes coming to the “boxed warning” section for chimeric antigen receptor T-cell therapies (CAR T) to highlight T-cell blood cancer risk; questions about the safety of obesity medications during pregnancy have arisen in women on them who previously struggled with fertility issues.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
Gene, Light Therapy Combo Shows Promise Against Prostate Cancer Cells in Proof-of-Concept Study
April 18th 2024In their preclinical model, the researchers found efficacy both in vitro and in vivo by using CRISPR-Cas9 to mimic porphyria and combining the technology with light therapy.
Read More
Pegcetacoplan for PNH More Cost-Effective Than Anti-C5 Monoclonal Antibodies
April 18th 2024A cost-utility analysis conducted from the perspective of the Italian health system found that pegcetacoplan was more effective and less costly than 2 complement 5 (C5) inhibitors for the treatment of paroxysmal nocturnal hemoglobinuria (PNH).
Read More