Treatment patterns and direct medical costs among patients with advanced hepatocellular carcinoma. (1st November 2020)

• Record Type: Journal Article
• Authors: Aly, Abdalla; Malangone-Monaco, Elisabetta; Noxon, Virginia; Henriques, Caroline; Benavente, Fernando; Kim, Amy
• Is Part Of: Current medical research and opinion. Volume 36:Number 11(2020)
• Page Start: 1813
• Page End: 1823
• Publication Date: 2020-11-01
• Subjects: Hepatocellular carcinoma economic burden treatment patterns; Clinical medicine -- Periodicals; Therapeutics -- Periodicals; 615.5
• DOI: 10.1080/03007995.2020.1824899
• Languages: English
• ISSNs: 0300-7995

Abstract

Abstract: Aims: This study assessed the real-world United States (US) treatment patterns and the associated economic burden in patients diagnosed with advanced hepatocellular carcinoma (HCC). Methods: The MarketScan database was used to identify patients newly diagnosed with HCC who received systemic therapy between 2011 and 2018 and continuously enrolled for ≥6 months (baseline period) prior and ≥1 month following HCC diagnosis. Treatment patterns (systemic and locoregional therapy), healthcare resource utilization, and costs were reported during follow-up. Results: The final sample included 1580 patients (median age, 61; 78% male; median follow up, 8.7 months). The most common first line of therapy (LOT) was sorafenib (78%). The median time from HCC diagnosis to start of sorafenib was 43 days, and the median duration of sorafenib therapy was 60 days. Only 17% of patients received second LOT, and non-sorafenib treatment use increased to 66% (mostly chemotherapy combination). Transarterial chemoembolization was the most commonly observed locoregional therapy prior to the first LOT. The multivariable-adjusted average all-cause total cost among sorafenib treated patients was $17, 642 (95% CI: $16, 711–$18, 558) per-patient per-month), of which $11, 393 were HCC-specific. Conclusions: In patients who received first-line therapy for HCC, the duration of therapy was short (potentially due to progression or tolerability). Most patients did not continue to second-line therapy. Despite the short duration of therapy, HCC patients still incur a high economic burden, and there is a need for more effective and tolerable treatments.