Service setting impact on costs for bevacizumab-treated oncology patients.
Am J Manag Care
; 20(11): e515-22, 2014 Nov 01.
Article
en En
| MEDLINE
| ID: mdl-25730350
ABSTRACT
OBJECTIVES:
To investigate treatment patterns and healthcare costs of patients with metastatic colorectal cancer (mCRC) or lung cancer (LC) who were treated with bevacizumab in a physician office (OFF) setting versus a hospital outpatient (HOP) setting. STUDYDESIGN:
Retrospective analysis of claims from a national US health plan.METHODS:
mCRC and LC patients initiating treatment with bevacizumab (index date) between January 1, 2006, and July 31, 2012, were identified. Patients were aged ≥18 years with ≥6-month pre- (baseline) and ≥6-month post index (follow-up) data, retaining patients who died with <6 months of follow-up. Differences by site of service were analyzed by χ2 and t test (bevacizumab administrations, dose) and general linear model adjusted for demographic and clinical characteristics (all-cause healthcare costs).RESULTS:
A total of 1687 mCRC (OFF 1292; HOP 395) and 1232 LC patients (OFF 983; HOP 249) were identified. Mean age was 61.3 years, 56.3% were male, and 78% were treated in OFF. Treatment in OFF declined from 2006 (84% of patients) to 2012 (61%). For OFF versus HOP, mean length of treatment (208.3 vs 191.0 days; P=.007), number of bevacizumab administrations per month (1.4 vs 1.1; P<.001), and mean weekly dose (eg, for 2012, 4.34 vs 3.11 mg/kg, P<.05) were higher in OFF. Adjusted monthly HOP costs (vs OFF) were higher by 37.8% for mCRC patients (cost ratio=1.378; 95% CI, 1.282-1.482) and 31.1% for LC patients (cost ratio=1.311; 95% CI, 1.204-1.427)CONCLUSIONS:
Despite fewer administrations and lower weekly dose of bevacizumab in HOP, adjusted total costs were 31% to 38% higher for mCRC and LC patients treated in the HOP setting.
Buscar en Google
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias Colorrectales
/
Anticuerpos Monoclonales Humanizados
/
Neoplasias Pulmonares
/
Antineoplásicos
Tipo de estudio:
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
Límite:
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Am J Manag Care
Asunto de la revista:
SERVICOS DE SAUDE
Año:
2014
Tipo del documento:
Article