OBJECTIVES: We investigated real-world baseline characteristics, treatment patterns, all cause and adverse event (AE)-related HCRU and HCC of patients with SCLC receiving up to 3 lines of treatment (LOTs) in the US.

METHODS: A retrospective, observational study leveraging Optum® Market Clarity data combining electronic health records with pharmacy and medical claims (July 2011 - September 2021). Eligible patients were those aged 18 years+ with limited stage (LS) or extensive stage (ES) SCLC, continuously enrolled in the health plan for ≥6 months prior to and ≥6 months after the date of first receipt of anti-tumor treatment.

RESULTS: The study included 2,233 patients; 69.7% had ES disease, their mean age was 64.8 years, 51.2% were female, 45.4% had a commercial insurance plan and their mean baseline Charlson comorbidity score was 6.5. Mean time-to-treatment initiation (TTI) from diagnosis was 35.4, 242.0, and 399.5 days in LOTs 1, 2, and 3 respectively. Mean time-to-treatment-discontinuation (TTD) was 132.9, 132.0, and 125.8 days in LOTs 1, 2, and 3, respectively. Treatment in LOT1 comprised platinum (PT)-based chemotherapy (CT) (61.0%), PT-CT with immune-checkpoint inhibitor (ICI) (15.2%), doxorubicin-based CT (13.4%), and other CT or ICI (10.4%). LOT2 comprised topotecan (24.8%), ICI (22.8%), CT monotherapy (22.9%), PT-CT (19.0%), other CT (10.5%). LOT3 comprised other monotherapy CT (40.8%), ICI (20.2%), topotecan (15.0%), PT-CT (14.3%) other CT combinations (9.8%). Ambulatory visits were the most utilized component of all-cause HCRU; 96.2% of patients in LOT 1, 94.6% in LOT2, 94.1% in LOT 3. Average total all-cause medical and pharmacy costs were $27,966.75, $26,499.29, and $23,396.92 per member per month (PMPM) in LOTs 1,2, and 3 respectively. The corresponding AE-related costs were $6,361.97, 6,315.86, $6464.12 PMPM in LOTs 1,2, and 3 respectively.

CONCLUSIONS: Patients with SCLC tend to have extensive-stage disease, and a high comorbidity burden, leading to substantial HCRU and HCC.