Abstract
Background:
Patients treated with epidermal growth factor receptor inhibitors (EGFRIs) may develop dermatologic adverse drug reactions (ADRs) that may affect patients’ quality-of-life, require medical care, and may lead to substantial costs. This study assessed the economic burden of dermatologic ADRs in colorectal cancer (CRC), head and neck cancer (HNC), and non-small cell lung cancer (NSCLC) patients.
Methods:
Adult patients with ≥1 diagnosis for the study cancer initiated on EGFRIs indicated for CRC, HNC, and NSCLC were selected from a large commercial database (MarketScan Commercial Database [2000–2010]; Thomas Reuters, New York, NY). For each cancer type, patients were classified into two mutually exclusive cohorts: ‘ADR’ (patients with ≥1 ADR following EGFRI initiation) and ‘ADR-free’ (patients without any ADR). Patients were observed from the index date up to the end of continuous healthcare plan enrollment or 90 days after EGFRI discontinuation, whichever occurred first. For each cancer group, the proportion of patients and the incidence rate (IR) of experiencing ≥1 dermatologic ADR were reported. Incidence rate ratios for healthcare resource utilization and monthly incremental costs (2010 USD) were estimated using Poisson regression and generalized linear or two-part models, respectively.
Results:
Overall, the proportion of patients with ≥1 ADR ranged between 20.5–36.4% across cancer groups (IR ranged between 44.2–57.4 per 100 patient-years). After adjusting for confounders, in each cancer group, ADR patients had higher incidence of healthcare resource utilization, generally driven by higher incidence of emergency room visits and incurred incremental total monthly healthcare costs that ranged between $2284–$3210 across cancer groups.
Limitations:
There was no clinical measure of cancer staging and ADR severity in the database.
Conclusions:
Results suggest that patients with CRC, NSCLC, and HNC, who may benefit from EGFRI therapies, may also incur a substantial economic burden that is associated with dermatologic ADRs.
Transparency
Declaration of funding
Funding for this study was provided by Abbott Laboratories.
Declaration of financial/other relationships
A. Guérin, G. Gauthier, E. Q. Wu, and M. Cloutier are employees of Analysis Group, Inc., which has received consultancy fees from Abbott Laboratories. K. D. Holen, S. Ray, and V. Bonthapally are Abbott Laboratories employees and hold Abbott stock.
Acknowledgments
No additional contributors to acknowledge. No assistance in the preparation of this article is to be declared.