Oncology Patients in Clinical Trials: A Health Care Cost Analysis

To assess health care resource utilization and costs among commercially insured patients with colorectal cancer (CRC) or ovarian cancer (OC) participating in clinical trials (PCTs).

A retrospective claims analysis from 2017 to 2022 was conducted using the Milliman Consolidated Health Cost Guidelines Sources Database, a proprietary database that aggregates deidentified claims data from multiple large commercial insurers representing more than 75 million covered lives.

Participants in CTs were identified with diagnosis, modifier, or procedure codes for a CT and a diagnosis code for either CRC or OC. The first observed CT claim was assigned as the index date (index). For patients with CRC or OC not participating in a CT, proxy episodes were created for each qualified 18-month period following the first observed cancer claim. We compared average allowed costs (per-patient-per-month) incurred in the 9 months following index after adjusting for confounding using inverse probability of treatment weighting.

We identified 69 CT participants with CRC, 40,716 nonparticipants with CRC, 49 CT participants with OC, and 17,041 nonparticipants with OC for the study. Adjusted mean costs for both medical and drugs, in the 9 months following index, were lower for CT participants than nonparticipants. Among CRC patients, mean medical costs were $2806 for the CT cohort vs $3996 for the non-CT cohort, a difference of $1190 ( P  = .015), and drug costs were $447 and $1635, respectively, a difference of $1189 ( P  = .0002). Among OC patients, mean medical costs were $2211 and $2508, respectively, a difference of $296 ( P  = .524), and mean drug costs were $371 and $2294, a difference of $1924 ( P  < .0001).

Commercially insured patients with OC and CRC enrolled in CTs incurred lower costs following CT initiation than those not enrolled, driven by payers not incurring costs for oncology therapies.