Introduction/Background Guidelines recommend surgery as primary therapy for endometrial cancer patients. Subsequent treatments can include radiation with/without systemic therapy depending on patients’ prognosis. However, there is little data describing real-world treatment patterns and economic burden among newly diagnosed endometrial cancer patients. Therefore, this study aimed to assess real-world treatment patterns and healthcare costs by line of therapy (LOT) among newly diagnosed endometrial cancer patients.
Methodology Endometrial cancer patients newly diagnosed between January 2015 – June 2018 with continuous medical enrollment for 12 months prior and 6 months post diagnosis were identified in the Optum Clinformatics DataMart database. Treatments associated with endometrial cancer, including surgeries (bilateral salpingo-oophorectomy, hysterectomy and lymphadenectomy), radiotherapy (external beam radiotherapy and brachytherapy) and systemic therapies (chemotherapies, immunotherapies and hormonal therapies) were identified and described by LOT. The first treatment received post diagnosis was classified as LOT1. Treatments initiated within ±90 days of surgical procedures, 30 days of the end of a radiotherapy, and 28 days of the start of a systemic therapy were considered to be a part of the same LOT. Study outcomes included time to treatment initiation, most frequently received treatments in LOT1 and LOT2, and per patient per month (PPPM) costs attributable to LOT1 and LOT2.
Results Among 5,006 newly diagnosed endometrial cancer patients, 3,574 (71%) received at least LOT1 and 771 (15.4%) received LOT2. The median time from diagnosis to LOT1 initiation was 1.0 (1.0 – 2.0) month. Hysterectomy (98.9%) was the most common treatment in LOT1. Majority of patients received radiation therapy (65%) in LOT2. Treatments received in LOT1 and LOT2 are summarized in table 1. The mean total healthcare cost from diagnosis to end of follow-up was $6,088 PPPM. The PPPM costs attributable to each LOT are presented in figure 1. The total healthcare costs during LOT2 exceeded those incurred during LOT1 with outpatient costs being the biggest driver.
Conclusion Newly diagnosed endometrial cancer patients received treatments consistent with guidelines with hysterectomy being the most common LOT1 treatment. Outpatient costs accounted for 70%-80% of total healthcare costs attributable to LOT1 and LOT2. Moving from LOT1 to subsequent LOTs was associated with an increase in healthcare costs which may be indicative of disease progression/recurrence.
Disclosures This study was funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. Chizoba Nwankwo is an employee of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. Anuj Shah, Ruchit Shah, Shelby Corman, and Nehemiah Kebede are employees of Pharmerit, which received consulting fees related to this study.
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