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Population-level changes in outcomes and Medicare cost following the introduction of new cancer therapies
- Source :
- Health Serv Res
- Publication Year :
- 2021
-
Abstract
- Objective To examine the population-level impacts of the introduction of novel cancer therapies with high cost in the United States, using immunotherapies in advanced nonsmall cell lung cancer (NSCLC) as an example. Data sources Surveillance, Epidemiology, and End Results data in 2012-2015 linked to Medicare fee-for-service claims until 2016. Study design We examined population-level trends in treatment patterns, survival, and Medicare spending in patients diagnosed with advanced NSCLC, the leading cause of cancer death in the United States, between 2012 and 2015. We estimated the percentage of patients who received any antineoplastic therapy within two years of diagnosis, including novel immunotherapies. We compared the trends in overall survival and mean two-year Medicare spending per each patient before and after the introduction of immunotherapies in 2015. Data collection/extraction methods Not Applicable. Principal findings The percentage of patients treated with any antineoplastic therapy remained the same at 46.7% in 2012 and 2015, whereas the use of immunotherapies increased from 0% to 15.2%. The two-year survival rate and median survival increased by 3.3 percentage points (95% CI: 2.0, 4.5) and 0.4 months (CI: 0.0, 0.9), respectively, during the same period. The mean two-year total Medicare spending and outpatient spending per patient increased by $5735 (CI: 3479, 8040) and $7661 (CI: 5902, 9311), respectively, which were largely attributable to the increases in immunotherapy spending by $5806 (CI: 5165, 6459). Conclusions The introduction of lung cancer immunotherapies was accompanied by improvements in survival and increases in spending between 2012 and 2015 in the Medicare population. As novel immunotherapies and other target therapies continue to change the clinical management of various cancers, further efforts are needed to ensure their effective and efficient use, and to understand their population-level impacts in the United States.
- Subjects :
- Male
medicine.medical_specialty
Lung Neoplasms
Population level
medicine.medical_treatment
Antineoplastic Agents
Medicare
03 medical and health sciences
0302 clinical medicine
Antineoplastic Agents, Immunological
Sex Factors
Internal medicine
Carcinoma, Non-Small-Cell Lung
Epidemiology
medicine
Humans
In patient
030212 general & internal medicine
Neoplasm Metastasis
Lung cancer
Survival rate
Aged
Neoplasm Staging
Aged, 80 and over
business.industry
030503 health policy & services
Health Policy
Racial Groups
Age Factors
Cancer
Immunotherapy
medicine.disease
Survival Analysis
United States
Medicare population
Female
Health Expenditures
0305 other medical science
business
SEER Program
Subjects
Details
- ISSN :
- 14756773
- Volume :
- 56
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Health services research
- Accession number :
- edsair.doi.dedup.....0ef4b9fdbe69513f46467529453dbaed