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. 2016 Apr;19(2):607-615.
doi: 10.1007/s10120-015-0486-z. Epub 2015 Mar 20.

Chemotherapy treatment patterns, costs, and outcomes of patients with gastric cancer in the United States: a retrospective analysis of electronic medical record (EMR) and administrative claims data

Lisa M Hess  1 , Diane Michael  2 , Daniel S Mytelka  2 , Julie Beyrer  2 , Astra M Liepa  2 , Steven Nicol  2
Affiliations

Chemotherapy treatment patterns, costs, and outcomes of patients with gastric cancer in the United States: a retrospective analysis of electronic medical record (EMR) and administrative claims data

Lisa M Hess et al. Gastric Cancer. 2016 Apr.

Abstract

Background: The aim of this study was to conduct a retrospective database analysis to describe the chemotherapy treatment patterns and outcomes of patients with gastric cancer.

Methods: Individuals diagnosed with gastric cancer were identified from the IMS Oncology Database, which contains electronic medical record (EMR) data collected from a variety of community practices, and the Truven Health MarketScan(®) Research database, an administrative claims database. Eligible patients were 18 years of age or older and had an ICD-9 code 151.0-151.9. Patients were excluded if they had evidence of cancer within 6 months of the index diagnosis.

Results: There were 5257 eligible patients identified in EMR data: 1982 (37.7 %) of these patients also had data regarding chemotherapy treatments. Of the 1982 patients who received first-line therapy, 42.3 %, 18.1 %, and 7.9 % went on to receive a second, third, and fourth line of chemotherapy, respectively. There were 11891 eligible patients identified in the administrative database; 5299 (44.6 %) had data regarding chemotherapy. Of those initiating chemotherapy, 2888 (54.5 %) received a second line and 1598 (30.2 %) received a third line of treatment. The average total cost of care during first-line therapy was $40,811 [standard deviation (SD) = $49,916], which was incurred over an average of 53.5 (SD = 63.4) days. A similar pattern was evident in second-line treatment (mean/SD, $26,588/$33,301) over 41.2 (SD = 55.7) days.

Conclusions: Costs and duration of care received vary among gastric cancer patients in the U.S. There is a need to understand which regimens may be associated with better health outcomes and to standardize treatment as appropriate.

Keywords: Economics, medical; Outcome assessment; Retrospective studies; Stomach neoplasms.

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Figures

Fig. 1
Fig. 1
Regimens used in second-line gastric cancer: administrative claims data (N = 2831)
Fig. 2
Fig. 2
Median estimated survival by stage: electronic medical record data (N = 1533)
See this image and copyright information in PMC

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