VP, Biostatistics Ontada Chestnut Hill, United States
Background: Despite a decline in incidence and an overall improvement in outcomes, OC remains the fifth leading cause of cancer deaths among women. However, standards of care for OC have significantly evolved over the past few years, especially following the approval of the first poly(ADP-ribose) polymerase inhibitor in 2014. In light of these advances, it is important to understand the ongoing cost burden associated with OC.
Objectives: The goal of this study was to evaluate the real-world outpatient cost of care among patients with OC in the community oncology setting.
Methods: This was a retrospective observational cohort study of patients diagnosed with OC within The US Oncology Network between January 2015 and December 2022. Data were sourced from iKnowMed™, an oncology-specific electronic health record system that captures outpatient practice encounter histories, demographics and clinical information for nearly 40% of US community oncology practices. Patient records were deterministically linked to claims and remittance data to capture costs for treatments received in the community oncology setting. Costs represent paid amounts in 2022 USD ($) and were analyzed descriptively as cost per patient per month (PPPM) longitudinally since 2015.
Results: This study included 6,872 eligible patients. The median (Q1, Q3) age at first visit was 65 (56, 73) years, and 71% were Caucasian. Patients came from all 4 census regions, with almost all patients treated in urban areas (97%). Patients were most commonly diagnosed with stage III (43%), followed by stage IV (19%). Diagnosis with stage I or II was less frequent (12% and 8%, respectively). The payer type was almost evenly split between Commercial (52%) and Medicare/Medicaid (47%). The median (Q1, Q3; same below) total outpatient medical care cost was $1,886 (695, 4,425) PPPM. Patients with more advanced disease showed higher PPPM costs, ranging from $652 (320, 1,459) for patients diagnosed with stage I to $2,936 (1,205, 5,392) for patients diagnosed with stage IV (p < 0.001). Over time, PPPM costs began rising since 2017, from $1,545 (541, 3,928) to $2,009 (877, 3,839) in 2022.
Conclusions: This retrospective study of patients with OC assessed the cost of care in community oncology settings in the US. Directionally, an increase in cost of care was observed starting in 2017, and costs were higher for more advanced disease. Taken together, these results may provide stakeholders with insights into how changes in the OC treatment landscape may influence costs and the potential cost benefits of early detection of OC.
