Real-World US Optum Claims Database Study of Pre- and Post-Relapse Costs and Health Care Resource Utilization (HCRU) in Patients With High-Risk Localized or Locally Advanced Prostate Cancer (HR-LPC/LAPC) Who Relapsed

Speaker(s)

Siebert U1, Bjartell A2, Nair S3, Lin X4, De Solda F5, Potluri R6, McCarthy SA7, Mundle SD7, McCallion J5, Jahn B8
1UMIT TIROL – University for Health Sciences and Technology, Hall in Tirol, Tirol, Austria, 2Skåne University Hospital, Lund University, Malmö, Sweden, 3Janssen Pharmaceutica NV, Beerse, Belgium, 4Janssen Global Services, Horsham, PA, USA, 5Janssen Global Services, Raritan, NJ, USA, 6Putnam Associates, HEOR & RWE, New York, NY, USA, 7Janssen Research & Development, Raritan, NJ, USA, 8UMIT TIROL – University for Health Sciences and Technology, Hall in Tirol, Hall i.T., 7, Austria

Presentation Documents

OBJECTIVES: Despite radical prostatectomy (RP) or radiotherapy (RT), patients with HR-LPC/LAPC are at risk of relapse, which may result in high economic burden. We assessed pre- and post-relapse HCRU and costs for HR-LPC/LAPC in the USA.

METHODS: US Optum Claims database was retrospectively searched (2010-2022) for patients with HR-LPC/LAPC (androgen-deprivation therapy [ADT]/RP/RT before relapse to nonmetastatic/metastatic castration-resistant PC, or metastatic castration-sensitive PC and <180 days from PC diagnosis) who relapsed. HCRU, including mean number of outpatient or lab visits for patients with ≥1 visit and mean aggregated length of hospital stay for those with ≥1 hospitalization, and costs, including total and medical, unadjusted or adjusted for patient characteristics, were analyzed pre-relapse (from ADT/RP/RT start to relapse) and post-relapse (from relapse to lost to follow-up/death) per-patient/per-month.

RESULTS: Among 62,529 patients with HR-LPC/LAPC who started RP or RT (median age 65 and 72 years, respectively), 8174 relapsed (4938 post-RP, 3236 post-RT) and were analyzed. Median follow-up was 2.7 years. A total of 7696 patients had subsequent treatment (ADT, salvage RT, or RP, alone or combination, in 79%).

Unadjusted HCRU pre-/post-relapse for RP was 1.58/2.24 (outpatient visits), 0.50/0.45 (lab visits), 0.29/0.36 months (hospital stay). For RT, HCRU was 2.95/2.44 (outpatient), 0.51/0.63 (lab) visits, and 0.41/0.76 months (hospital stay).

Mean duration of pre-/post-relapse states was 15.8/32.4 and 28.9/25.6 months for RP and RT groups, respectively.

For RP, mean unadjusted costs pre-/post-relapse were US$3912.90/3753.90 (total) and US$3681.00/3001.10 (medical). For RT, pre-/post-relapse costs were US$4347.30/5237.70 (total) and US$4014.20/3820.60 (medical).

Results of adjusted analyses will follow.

CONCLUSIONS: Real-world costs and resource utilization were high for patients who relapsed from HR-LPC/LAPC after RP or RT with curative intent, with higher overall costs for RT, although duration of pre-/post-relapse states may impact interpretation. An unmet need exists for new treatment protocols that reduce risk of relapse and need for salvage therapies.

Code

EE336

Topic

Economic Evaluation

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, Oncology