Cost and Health-Care Utilization With Targeted Drug Delivery Plus Conventional Medical Management for Cancer-Related Pain
Results of a study published by Stearns et al in JAMA Network Open demonstrated a reduction in health-care utilization and cost for patients cancer-related pain using targeted drug delivery and conventional medical management vs conventional medical management alone.
The study found significant cost savings to payers, with fewer inpatient visits, shorter inpatient length of stay, and fewer emergency department visits for the targeted drug delivery plus conventional medical management group. Over 12 months, targeted drug delivery was associated with a significant mean overall cost savings of $63,498 and fewer oral opioid prescriptions per patient.
Targeted drug delivery is an alternative to oral opioids for patients. It provides effective pain relief at a smaller dose with fewer side effects and may help reduce the use of oral opioids.
“Targeted drug delivery should be considered as an option for patients with cancer-related pain,” said lead study author Lisa J. Stearns, MD, of the Center for Pain and Supportive Care. “It is proven safe and effective for [patients with] cancer pain, offering pain relief and improvements in quality of life. Now, targeted drug delivery also demonstrates a robust financial benefit, which is especially significant as the incidence and societal burden of cancer continues to increase.”
More on the Study
The paper reported the results of a retrospective propensity-score matched analysis conducted using a large U.S. claims database comparing mean total commercial payer costs and health-care utilization at 2, 6, and 12 months. Researchers matched commercial insurance beneficiaries with patients with severe uncontrolled cancer pain receiving targeted drug delivery and conventional medical management or conventional medical management alone. Participants were matched on age, sex, cancer type, comorbidity score, and pre-enrollment characteristics. After matching, each group included 268 patients.
The study found that compared with conventional medical management alone, targeted drug delivery and conventional medical management demonstrated the following per patient:
- A mean total cost savings of $15,142 at 2 months and $63,498 at 12 months; cost savings at 6 months were not statistically significant
- Fewer inpatient visits at 2 months, 6 months, and 12 months
- Shorter hospital stays at 2 months (mean difference = 6.8 days), 6 months (mean difference = 6.8 days), and 12 months (mean difference = 10.6 days)
- An association with fewer prescriptions for oral opioids at 12 months.
Use of conventional medical management only was associated with greater opioid use at 12 months.
The study authors concluded, “Compared with [conventional medical management] alone, [targeted drug delivery] and [conventional medical management] together were associated with significantly lower cost and health-care utilization. The findings suggest that [targeted drug delivery] is a cost-saving therapy that should be considered in patients with cancer for whom oral opioids are inadequate or produce intolerable adverse effects, and should be expanded as health-care systems transition to value-based models.”
Disclosure: The study authors’ full disclosures can be found at jamanetwork.com.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
