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Docetaxel chemotherapy in metastatic castration-resistant prostate cancer: cost of care in Medicare and commercial populations.

Publication ,  Conference
Armstrong, A; Bui, C; Fitch, K; Sawhney, TG; Brown, B; Flanders, S; Balk, M; Deangelis, J; Chambers, J
Published in: Curr Med Res Opin
June 2017

OBJECTIVE: To estimate the healthcare costs and characteristics of docetaxel chemotherapy episodes of care for men with metastatic castration-resistant prostate cancer (mCRPC). METHODS: This study used the Medicare 5% sample and MarketScan Commercial (2010-2013) claims data sets to identify men with mCRPC and initial episodes of docetaxel treatment. Docetaxel episodes included docetaxel claim costs from the first claim until 30 days after the last claim, with earlier termination for death, insurance disenrollment, or the end of a 24-month look-forward period from initial docetaxel index date. Docetaxel drug claim costs were adjusted for 2011 generic docetaxel introduction, while other costs were adjusted to 2015 values using the national average annual unit cost increase. RESULTS: This study identified 281 Medicare-insured and 155 commercially insured men, with 325 and 172 docetaxel episodes, respectively. The average number of cycles (unique docetaxel infusion days) per episode was 6.9 for Medicare and 6.3 for commercial cohorts. The average cost per episode was $28,792 for Medicare and $67,958 for commercial cohorts, with docetaxel drug costs contributing $2,588 and $13,169 per episode, respectively. The average cost per episode on docetaxel infusion days was $8,577 (30%) for Medicare and $28,412 (42%) for commercial. Non-docetaxel infusion day costs included $7,074 (25%) for infused or injected drugs for Medicare, $10,838 (16%) for commercial cohorts, and $6,875 (24%) and $9,324 (14%) for inpatient admissions, respectively. LIMITATIONS: The applicability is only to the metastatic castration-resistance clinical setting, rather than the metastatic hormone-sensitive setting, and the lack of data on the cost effectiveness of different sequencing strategies of a range of systemic therapies including enzalutamide, abiraterone, radium-223, and taxane chemotherapy. CONCLUSION: The majority of docetaxel episode costs in Medicare and commercial mCRPC populations were non-docetaxel drug costs. Future research should evaluate the total cost of care in mCPRC.

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Published In

Curr Med Res Opin

DOI

EISSN

1473-4877

Publication Date

June 2017

Volume

33

Issue

6

Start / End Page

1133 / 1139

Location

England

Related Subject Headings

  • United States
  • Taxoids
  • Radium
  • Prostatic Neoplasms, Castration-Resistant
  • Phenylthiohydantoin
  • Nitriles
  • Middle Aged
  • Medicare
  • Male
  • Humans
 

Citation

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Armstrong, A., Bui, C., Fitch, K., Sawhney, T. G., Brown, B., Flanders, S., … Chambers, J. (2017). Docetaxel chemotherapy in metastatic castration-resistant prostate cancer: cost of care in Medicare and commercial populations. In Curr Med Res Opin (Vol. 33, pp. 1133–1139). England. https://doi.org/10.1080/03007995.2017.1308919
Armstrong, A., C. Bui, K. Fitch, T Goss Sawhney, B. Brown, S. Flanders, M. Balk, J. Deangelis, and J. Chambers. “Docetaxel chemotherapy in metastatic castration-resistant prostate cancer: cost of care in Medicare and commercial populations.” In Curr Med Res Opin, 33:1133–39, 2017. https://doi.org/10.1080/03007995.2017.1308919.
Armstrong A, Bui C, Fitch K, Sawhney TG, Brown B, Flanders S, et al. Docetaxel chemotherapy in metastatic castration-resistant prostate cancer: cost of care in Medicare and commercial populations. In: Curr Med Res Opin. 2017. p. 1133–9.
Armstrong, A., et al. “Docetaxel chemotherapy in metastatic castration-resistant prostate cancer: cost of care in Medicare and commercial populations.Curr Med Res Opin, vol. 33, no. 6, 2017, pp. 1133–39. Pubmed, doi:10.1080/03007995.2017.1308919.
Armstrong A, Bui C, Fitch K, Sawhney TG, Brown B, Flanders S, Balk M, Deangelis J, Chambers J. Docetaxel chemotherapy in metastatic castration-resistant prostate cancer: cost of care in Medicare and commercial populations. Curr Med Res Opin. 2017. p. 1133–1139.

Published In

Curr Med Res Opin

DOI

EISSN

1473-4877

Publication Date

June 2017

Volume

33

Issue

6

Start / End Page

1133 / 1139

Location

England

Related Subject Headings

  • United States
  • Taxoids
  • Radium
  • Prostatic Neoplasms, Castration-Resistant
  • Phenylthiohydantoin
  • Nitriles
  • Middle Aged
  • Medicare
  • Male
  • Humans