In a study presented by Picozzi et al at the 2020 Gastrointestinal Cancers Symposium, researchers found that even as drug costs increased over the past decade, total inflation-adjusted pancreatic cancer care expenses declined, as did costs related to quality of life (Abstract 773).
Health technology assessment programs are increasingly using real-world patient data to assess the effect of new medicines on total cost of care. This study analyzed such data to measure the impact of new pancreatic cancer therapies on other nontherapeutic medical expenditures.
“There is a great need to develop new treatments for pancreatic cancer that balance both efficacy and safety,” said first study author Vincent J. Picozzi, MD, Director of the Pancreaticobilliary Program at the Floyd & Delores Jones Cancer Institute at the Virginia Mason Medical Center. “The value of advancing treatments is apparent from our total cost-of-care analysis looking at both medical and pharmacotherapy costs. Our study looked at treatment inflation-adjusted expenses per patient for pancreatic cancer care between 2009 and 2016, and found that for every additional $1 spent on drugs for pancreatic cancer, there was a reduction in nondrug spending of $9.”
Methodology
The study analyzed longitudinal patient-level data from the Medical Expenditure Panel Survey (1996–2017). Researchers evaluated 80 patients who had a diagnosis of pancreatic cancer and available prescription data. Individual age and employment status were accounted for as covariates.
All analyses were performed using R version 3.6.1 on Ubuntu 19.04. Means and standard deviations were computed for the raw and inflation-adjusted total health-care costs, excluding drug spending. Study averages were computed for the total health-care costs, including prescription medicine costs for the period between 2009-2016 which included approval and use of novel treatment approaches such as nab-paclitaxel, FOLFIRINOX (leucovorin/fluorouracil/irinotecan/oxaliplatin), and erlotinib. The prescription medicines expenses and proportion of health-care spending were also plotted along with a LOESS curve using the same parameters. All expenditures are adjusted for inflation using 2012 U.S. dollars.
KEY POINTS
- Between 2009 and 2016, average inflation-adjusted per patient spending on pancreatic cancer care declined from $37,000 to $10,000.
- Prescription drug spending increased during the same time period—from $2,400 to $5,300 per person (inflation-adjusted).
Results
Between 2009 and 2016, average inflation-adjusted per patient spending on pancreatic cancer care declined from $37,000 to $10,000. Prescription drug spending increased during the same time period—from $2,400 to $5,300 per person (inflation-adjusted). In effect, for every additional dollar spent on therapies for pancreatic cancer between 2009 to 2016, there was a reduction in nondrug spending of $9.
Total cost of care for patients in this analysis reached a maximum of $280,443 and $312,077 for the first and second year of care, respectively. Also, between 1997 and 2016, inflation-adjusted first- and second-year nonmedication charges on pancreatic cancer care averaged $66,999.96 and $105,308.60, respectively. Lost work/school days declined between 2007 and 2017.
The authors concluded, “Further analysis is needed to evaluate the relationship between drug spending, total cost of care, and quality of life.”
Disclosure: For full disclosures of the study authors, visit coi.asco.org.
