scholarly journals Validation of a Case-Finding Algorithm for Identifying Patients with Non-small Cell Lung Cancer (NSCLC) in Administrative Claims Databases

2017 ◽  
Vol 8 ◽  
Author(s):  
Ralph M. Turner ◽  
Yen-Wen Chen ◽  
Ancilla W. Fernandes
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Case Finding ◽  
Small Cell ◽  
Administrative Claims ◽  
Small Cell Lung

Comparison of treatment patterns, health care utilization, and direct costs in elderly patients with distant-stage small cell lung cancer (SCLC) versus non-small cell lung cancer (NSCLC) using the SEER-Medicare database.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 7101-7101
Author(s):  
Sudeep Karve ◽  
Gregory Price ◽  
Keith L. Davis ◽  
Gerhardt Pohl ◽  
Emily Nash Smyth
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Treatment Patterns ◽  
Small Cell ◽  
Administrative Claims ◽  
Small Cell Lung ◽  
Total Lifetime ◽  
Medicare Database

7101 Background: Limited data exist on real-world treatment patterns, healthcare utilization, and associated costs of advanced SCLC among elderly patients in the US, and there are no recent comparisons between patients with advanced SCLC and advanced NSCLC. Methods: We retrospectively analyzed administrative claims data for elderly patients (≥65 years) from the linked Surveillance, Epidemiology and End Results (SEER)-Medicare database for 2000-2008. Patients with a new diagnosis of distant stage lung cancer receiving cancer-directed therapy (ie, surgery, radiation, biologics, and/or chemotherapy) were grouped by tumor type (SCLC [n=5,855] vs NSCLC [n=24,090]). Survival was compared using Kaplan-Meier Log-rank; categorical measures with Chi-square statistics; and continuous measures with t-tests. Results: Compared to SCLC patients, a significantly greater proportion of patients with NSCLC received radiation therapy (75.6% vs 65.4%; p<0.001) and surgery (13.6% vs 7.8%; p<0.001). Chemotherapy was received by 85.5% of SCLC patients and 60.3% of NSCLC patients (p<0.001). Significantly higher proportions of SCLC patients also received red blood cell (20.7% vs 10.9; p<0.001) and platelet transfusions (5.6% vs 1.8%; p<0.001) as well as growth factor support (58.9% vs 39.5%; p<0.001). Survival did not differ significantly between groups (p=0.424), with the mean (10.4 months vs 11.1 months) and median (7.4 months vs 5.9 months) survival for SCLC and NSCLC noted accordingly. Total lifetime lung cancer-related costs ($44,167 vs $37,932; p<0.001) and all-cause costs ($70,548 vs $67,175; p<0.001) per patient for SCLC exceeded those for NSCLC. The primary drivers of cost included resource utilization across 3 care settings: hospitalizations, office visits, and hospital outpatient visits. Conclusions: Overall total lifetime and disease-related costs per advanced SCLC and NSCLC patient were high, and costs for SCLC exceeded those for NSCLC. Survival estimates coupled with per patient costs for both cancers underscores the unmet medical need for patients with distant stage SCLC and NSCLC.

Complications and Economic Burden Associated with Obtaining Tissue for Diagnosis and Molecular Analysis in Patients with Non-Small Cell Lung Cancer (NSCLC) in the US (Preprint)

2018 ◽  
Author(s):  
Ronan Kelly ◽  
Ralph Turner ◽  
Yen-Wen Chen ◽  
James R. Rigas ◽  
Ancilla W. Fernandes ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Molecular Testing ◽  
Administrative Claims ◽  
Complication Rates ◽  
Testing Methods ◽  
Small Cell Lung ◽  
The Us

BACKGROUND Tissue biopsy to identify targetable genomic and immunologic alterations is the mainstay of managing patients with non-small cell lung cancer (NSCLC); however, little is known about the associated economic impact and complication rates. OBJECTIVE This study assesses the frequency, complications and costs of diagnostic and post-progression biopsy. METHODS This retrospective, observational study was conducted using administrative claims data from over 30 million commercially insured individuals in the US (2006-2014). Data were analyzed for the overall population and by time of biopsy (diagnostic or post-progression). RESULTS Of 20,013 eligible patients, 13,411 (67%) received a diagnostic biopsy, whereas only 2,056 (10%) received a post-progression biopsy; mean cost: $9,977 and $16,806, respectively. Complication rates were similar at diagnosis and post-progression, on the day of biopsy (10% vs 7%) and within 30 days (63% vs 61%). Mean costs were higher among patients with a complication vs those without, on the day of biopsy (diagnostic: $12,030 vs $6,508; post-progression: $22,593 vs $7,812) and within 30 days (diagnostic: $24,968 vs $15,988; post-progression: $30,293 vs $12,494) (P< .001 for all comparisons). CONCLUSIONS From 2006 to 2014, post-progression biopsies were not common practice in NSCLC. Complication rates were similar at diagnosis and post-progression, with mean costs higher among patients with a complication than those without. With increasing demands for effective novel targeted therapies and safe testing methods for patients, providers, and payers, these data may be valuable in determining the budget impact and comparing complication rates with newer, less invasive molecular testing methods, including plasma circulating tumor DNA testing.

scholarly journals Real-World Treatment Patterns, Clinical Outcomes, and Health Care Resource Utilization in Extensive-Stage Small Cell Lung Cancer in Canada

2021 ◽  
Vol 28 (4) ◽  
pp. 3091-3103
Author(s):  
Dylan E. O’Sullivan ◽  
Winson Y. Cheung ◽  
Iqra A. Syed ◽  
Daniel Moldaver ◽  
Mary Kate Shanahan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Real World ◽  
Small Cell ◽  
Administrative Claims ◽  
Small Cell Lung ◽  
First Line ◽  
Extensive Stage ◽  
Third Line

The prognosis for extensive-stage small cell lung cancer (ES-SCLC) is poor. Real-world evidence can highlight the unmet clinical need within this population. We conducted a population-based cohort study of ES-SCLC patients diagnosed in a large Canadian province (2010–2018) using electronic medical records and administrative claims data. In all, 1941 ES-SCLC patients were included, of which 476 (25%) were recurrent cases. Median age at diagnosis was 70 years (range: 39–94) and 50.2% were men. Of the 1941 ES-SCLC patients, 29.5% received chemotherapy and radiotherapy, 17.0% chemotherapy alone, 8.7% radiotherapy alone, and 44.8% received best supportive care. Chemotherapy was initiated by 46.5%, 8.5%, and 1.4% of first-, second-, and third-line patients, with lower uptake for recurrent cases. Median survival from first-, second-, and third-line chemotherapy was 7.82 months (95% CI: 7.50–8.22), 5.72 months (95% CI: 4.90–6.87), and 3.83 months (95% CI: 2.99–4.60). Among patients who received first-line therapy, the 2-year and 5-year survival was 7.3% (95% CI: 5.7–9.2) and 2.9% (95% CI: 1.8–4.5). In conclusion, initiation of first-line treatment in ES-SCLC was low with significant attrition in subsequent lines. These results underscore the need for effective front-line treatments and highlight the potential for novel therapies to improve patient outcomes.

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