Product information and disease description Place of product in therapy Disease description Burden of Second-line advanced biliary tract cancer

Economic burden and healthcare resource utilization

7 evidence topics · 3 sources

Summary: costs and resource use in advanced biliary tract cancer

In a United States commercially insured cohort of participants with advanced biliary tract cancer treated before immuno-oncology regimens were approved, mean per-patient-per-month all-cause costs were $18,274 overall, of which approximately 84% ($15,296) were biliary-tract-cancer-related. Costs rose with each line of therapy, from $19,589 in first line to $22,617 in second line and $33,534 in third line. Outpatient and inpatient utilization were the main cost drivers, and approximately 70% of participants had at least one inpatient visit. Earlier estimates cited in the same study were $7,743 per-patient-per-month for advanced cholangiocarcinoma-associated costs after first-line failure and $20,696 per-patient-per-month for all-cause biliary tract cancer management. In a separate claims analysis of participants receiving pemigatinib, mean per-patient-per-month medical costs were $13,444 for those with a prior cancer-of-unknown-primary diagnosis and $9,881 for those without.

Economic burden: per-patient-per-month costs by line of therapy

“The mean PPPM costs for the overall population were $18,274 for all-cause costs, of which approximately 84% ($15,296) comprised BTC-related costs.” (opens the source at this quote in a new tab)
“The total mean (SD) PPPM all-cause costs by LOT were $19,589 ($22,603) for 1LOT, $22,617 ($19,302) for 2LOT and $33,534 ($40,588) for 3LOT.” (opens the source at this quote in a new tab)
“We found that total all-cause PPPM cost was $19,589 during 1LOT, increasing to $22,617 and $33,534 as the treatment advanced to 2LOT and 3LOT, respectively, with >80% of PPPM costs only related to BTC.” (opens the source at this quote in a new tab)
“The primary driver of costs across all three LOTs was outpatient (including antineoplastic therapy visits) and inpatient utilization followed by outpatient pharmaceutical costs.” (opens the source at this quote in a new tab)

Economic burden: previously published cost estimates

“One study focused on costs of second-line therapies in selected patients with advanced cholangiocarcinoma who experienced failure of a first-line therapy containing either gemcitabine or fluorouracil; the total mean per-patient-per-month (PPPM) advanced cholangiocarcinoma-associated healthcare costs were $7,743 [20]. Another study noted high total all-cause healthcare costs of $20,696 PPPM for the management of BTC; however, this study did not account for disease stage or 1LOT using a validated clinical data source [21].” (opens the source at this quote in a new tab)

Economic burden: complications as cost drivers

“Healthcare professionals could implement strategies to identify and prevent some of these complications at an early stage and initiate pre-emptive discussions regarding advanced treatment options and patient preferences for further management to limit excess costs.” (opens the source at this quote in a new tab)
“In addition to the unmet treatment needs of patients with advanced BTC, the care costs pose a significant burden on patients and payers that has increased over time [20].” (opens the source at this quote in a new tab)

Economic burden: resource use and cost in a targeted-therapy cohort

“CUP was associated with significantly higher prevalence of metastatic disease (100.0% vs 63.6%), per patient per month (PPPM) ambulatory HCRU (8.2 vs 5.5), and ambulatory costs ($8584 vs $5308). Medical costs averaged $13 444 vs $9881 PPPM for CUP and non-CUP, respectively (P = .066). Median OS was significantly shorter with CUP (10.2 vs 30.7 months).” (opens the source at this quote in a new tab)

Economic burden: direct medical costs in an employed population

“Patients with iCCA vs. eCCA had higher inpatient, outpatient medical, outpatient pharmacy, and all-cause healthcare costs PPPM.” (opens the source at this quote in a new tab)
“Patients with CCA had high productivity losses, indirect costs, and medical costs. Outpatient services costs contributed greatly to the higher healthcare expenditure observed in patients with iCCA vs. eCCA.” (opens the source at this quote in a new tab)
“Whereas reported costs from the previous analysis were higher than the mean all-cause healthcare costs (range: $10,321–$11,175) and inpatient costs (range: $3,798–$4,883) PPPM across CCA cohorts in our analysis, these disparities may be owing to differences in the patient inclusion criteria of each analysis; selecting for patients with previously treated CCA may have resulted in an older patient population with more advanced disease.” (opens the source at this quote in a new tab)

Economic burden: inpatient admission rates in an employed cholangiocarcinoma cohort

“The percentage of patients with CCA, iCCA, or eCCA being admitted to the hospital were similar across each cohort of absenteeism (75.7, 72.1, and 78.0%, respectively), short-term disability (75.9, 73.9, and 75.3%, respectively), and long-term disability (73.8, 71.2, and 74.5%, respectively).” (opens the source at this quote in a new tab)