In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 34_suppl ( 2012-12-01), p. 126-126
Abstract:
126 Background: Erlotinib is an oral oncology drug FDA-approved for advanced pancreatic and non-small cell lung cancers. Data on its patterns of use, pharmacy dispensing, and patient’s OOP are scarce. Methods: Using integrated medical and pharmaceutical data from 4 Blue Cross Blue Shield plans, we retrospectively identified individuals who received erlotinib between 01/2011 and 06/2011. Their claims were further queried for neoplasm ICD9 codes. A new user was defined as having no erlotinib claims filed in the prior 180 days. All new users were followed for 180 days or until their death/disenrollment (censor date). Excess erlotinib tablets were calculated for individuals with a censor date. The cost of unused tablets was estimated considering the standard 30-day, as well as a hypothetical 15-day drug supply. A gap of 45 days without erlotinib, during the follow-up, was defined as non-persistent to erlotinib therapy. The OOP costs were recorded from their first erlotinib claim. Results: Among 3,357,936 members insured, 125 (40 per million) received erlotinib in the period; 102 members (81.6%) had a lung cancer diagnosis, 18 (14.4%) pancreatic cancer, and 5 (4%) had cancers where erlotinib use is not evidence-based; 31 (24.8%) had a total cumulative supply of less than 30 days suggesting one fill and then discontinuation; 60 patients (48%) were new users in the period, 47 with lung cancer and 12 with pancreatic cancer. Among new users, 27 (45%) died or disenrolled; 18 (30%) of these patients had 211 unused tablets, which amounted to $35,237 or $587 per new user. With a hypothetical 15-day drug supply, there would be 45 unused tablets, totaling $7,515 or $125 per new user. Among the 60 new users, individual OOP on their first claim was 〈 $100 for 38 (63.3%) individuals and 〉 $100 for 22 (36.7%). OOP greater than $100 was associated with a 45-day gap in erlotinib therapy over the 6-month period, p=0.047 (21.0% versus 45.5%). Conclusions: A fourth of patients received erlotinib for less than a month, indicating these patients were either at the end of their lives or had intolerable toxicities. In this cohort, higher OOP costs negatively impacted persistence to therapy. For new users, a care management program with a 15-day drug supply could potentially be a cost-saving approach.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2012.30.34_suppl.126
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2012
detail.hit.zdb_id:
2005181-5
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