Health Care Resource Use Among Patients with Advanced Non-Small Cell Lung Cancer in Japan, 2017-2019.

Area of Science:

• Oncology
• Health Services Research
• Pharmacoeconomics

Background:

• First-line immune checkpoint inhibitor (ICI) monotherapy for advanced non-small cell lung cancer (NSCLC) was introduced in Japan in 2017.
• Limited data exists on healthcare resource utilization for NSCLC in Japan, a country with a high hospitalization burden.
• Understanding resource use is crucial for managing advanced NSCLC treatment costs and patient care.

Purpose of the Study:

• To evaluate healthcare resource use in patients with advanced NSCLC receiving first- through third-line systemic anticancer therapy in Japan.
• To compare resource utilization across different first-line treatment regimens: ICI monotherapy, platinum-doublet chemotherapy, and nonplatinum regimens.
• To analyze trends in hospitalizations and outpatient visits per patient-week across therapy lines.

Main Methods:

• Retrospective chart review of 1208 patients with advanced NSCLC at 23 Japanese hospitals.
• Inclusion criteria: age ≥20 years, unresectable locally advanced/metastatic NSCLC, no known actionable genomic alteration, initiated first-line therapy between July 2017 and December 2018.
• Data collected on hospitalizations, outpatient visits, and treatment regimens (ICI monotherapy, platinum-doublet chemotherapy, nonplatinum regimens) up to September 2019.

Main Results:

• Majority of patients (76%-94%) had ≥1 hospitalization and (85%-90%) ≥1 outpatient visit per therapy line.
• Hospitalizations per 100 patient-weeks increased from 6.5 (first-line) to 8.0 (third-line).
• First-line ICI monotherapy showed lower hospitalization rates (4.8/100 patient-weeks) compared to platinum-doublet chemotherapy (8.4/100 patient-weeks).

Conclusions:

• Significant variations in healthcare resource use exist among different first-line systemic therapy regimens for advanced NSCLC in Japan.
• Resource use, including hospitalizations and outpatient visits, generally increased with subsequent lines of therapy.
• Further research is warranted to investigate the drivers of these regimen-specific differences in resource utilization.