Treatment patterns, clinical and economic outcomes of patients with anaplastic lymphoma kinase-positive non-small cell lung cancer receiving ceritinib: a retrospective observational claims analysis

Abstract

Objective: To describe patient characteristics, treatment patterns, healthcare resource utilization (HRU), and costs among patients with anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) receiving ceritinib in second or later line of therapy.

Methods: Adult patients with NSCLC receiving ceritinib were identified from two large US claims databases (2006–2015). Patient characteristics, comorbidity profile, treatment patterns prior to ceritinib, and ceritinib dosing patterns were described. All-cause, HRU, and costs incurred during the observation period after ceritinib initiation were reported per patient per six months.

Results: One hundred sixty-four patients were included (mean age 54.2 years, 57.3% female); the majority had metastatic disease (94.5%) and the average Charlson Comorbidity Index was 7.6. 150 (91.5%) patients received crizotinib prior to ceritinib – average crizotinib duration was 10.2 months and time between crizotinib discontinuation and ceritinib initiation was 2.1 months (median= 0; 25th–75th percentile= 0–0.8). Most patients (73.8%) initiated ceritinib on the recommended dose (750 mg) and maintained the dose until the end of the observation period (mean of 7.4 months) or ceritinib discontinuation; 61 (37.2%) patients discontinued ceritinib during the observation period. A total of 76 (46.3%) patients had at least one inpatient admission during the observation period after ceritinib initiation. Mean total healthcare cost per patient per six months was $111,468.

Conclusions: Patients with ALK-positive NSCLC receiving ceritinib had a high comorbidity burden and generally started ceritinib on the recommended dose quickly after crizotinib discontinuation. Medical costs accounted for nearly a half of the total healthcare costs.

Keywords:

• Non-small cell lung cancer
• anaplastic lymphoma kinase
• ceritinib

Acknowledgements

We would like to thank Cinzia Metallo, PhD, an employee of Analysis Group, Inc., for medical writing assistance.

Preliminary data were presented at the AMCP Annual Meeting 2017, on 27–30 March 2017 in Denver, Colorado.

Declaration of interest

AAD, AM, and KWC are employees of Novartis Pharmaceuticals Corporation and may own stock or stock options. AG is an employee of Analysis Group, Inc., which has received consultancy fees from Novartis for this work. JDA peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

Financial support for this study was provided by Novartis Pharmaceuticals Corporation.