Healthcare resource utilization and costs associated with patients prescribed afatinib or erlotinib as first-line therapy for EGFR mutation-positive NSCLC in the United States

Figures & data

Figure 1. Sample selection. Abbreviation. NSCLC, non-small cell lung cancer. Reproduced with permission from Future Oncology.

Table 1. Baseline characteristics among the cohort of patients treated with afatinib and erlotinib before and after propensity score matching.

Demographic and clinical characteristics	Before matching		After matching
	Erlotinib (n = 2,602)	Afatinib (n = 550)	Erlotinib (n = 525)	Afatinib (n = 525)
Age, years, mean ± SD	67.1 (12.0)*	63.3 (11.4)*	64 (11.7)	63.8 (11.3)
Age category; n (%)
18‒34 years	8 (0.3)	0 (0.0)	0 (0.0)	0 (0.0)
35‒49 years	149 (5.7)*	57 (10.4)*	47 (9.0)	49 (9.3)
50‒54 years	221 (8.5)*	71 (12.9)*	63 (12.0)	66 (12.6)
55‒59 years	336 (12.9)*	89 (16.2)*	87 (16.6)	81 (15.4)
60‒64 years	501 (19.3)	104 (18.9)	113 (21.5)	101 (19.2)
≥65 years	1387 (53.3)*	229 (41.6)*	215 (41.0)	228 (43.4)
Sex; n (%)
Male	921 (35.4)	195 (35.5)	179 (34.1)	184 (35.0)
Female	1681 (64.6)	355 (64.5)	346 (65.9)	341 (65.0)
US region; n (%)
Northeast	525 (20.2)*	139 (25.3)*	128 (24.4)	126 (24.0)
North-central	560 (21.5)	100 (18.2)	97 (18.5)	99 (18.9)
South	866 (33.3)*	224 (40.7)*	212 (40.4)	213 (40.6)
West	624 (24.0)*	87 (15.8)*	88 (16.8)	87 (16.6)
Unknown	27 (1.0)*	0 (0.0)*	0 (0.0)	0 (0.0)
Deyo-modified CCI Score, mean ± SD	8.1 (3.0)*	8.5 (2.5)*	8.3 (2.4)	8.5 (2.5)
Individual Comorbidities; n (%)
Cerebrovascular disease	429 (16.5)*	60 (10.9)*	53 (10.1)	60 (11.4)
Coronary heart disease	373 (14.3)	71 (12.9)	64 (12.2)	67 (12.8)
Myocardial infarction	108 (4.2)	16 (2.9)	10 (1.9)	16 (3.0)
Heart failure	204 (7.8)	30 (5.5)	23 (4.4)	29 (5.5)
Peripheral arterial disease	295 (11.3)*	44 (8.0)*	39 (7.4)	44 (8.4)
Diabetes mellitus	520 (20.0)	96 (17.5)	67 (12.8)	88 (16.8)
Chronic kidney disease	220 (8.5)*	32 (5.8)*	27 (5.1)	32 (6.1)
Liver disease	453 (17.4)	93 (16.9)	94 (17.9)	86 (16.4)
COPD	974 (37.4)*	174 (31.6)*	172 (32.8)	168 (32.0)

* Characteristics with statistically significant (p < 0.05) differences between cohorts.

Abbreviations. CCI, Charlson Comorbidity Index; COPD, chronic obstructive pulmonary disease; SD, standard deviation.

Table 2. Adjusted healthcare resource utilization and number of visits per patient per month among the cohort of patients treated with afatinib and erlotinib.

	Erlotinib (n = 525)	Afatinib (n = 525)	Mean difference (95% CI)	p-value
All-cause healthcare resource utilization, mean (%)
Patients with ≥1 inpatient visit	274 (52.2)	212 (40.4)	0.8 (0.68, 0.88)	0.0001
Patients with ≥1 outpatient ER visit	284 (54.1)	240 (45.7)	0.8 (0.75, 0.95)	0.0066
Patients with ≥1 outpatient office visit	481 (91.6)	483 (92.0)	1.0 (0.97, 1.04)	0.8219
Patients with ≥1 other outpatient visit	509 (97.0)	503 (95.8)	1.0 (0.97, 1.01)	0.3215
Number of visits PPPM, mean (95% CI)
Inpatient length of stay	1.3 (1.0–1.6)	1 (0.8–1.3)	−0.30 (–0.65, 0.10)	0.1491
Inpatient visits	0.2 (0.1–0.2)	0.1 (0.1–0.1)	−0.04 (–0.07, –0.01)	0.0152
Outpatient ER visits	0.1 (0.1–0.2)	0.1 (0.1–0.1)	−0.02 (–0.05, 0.01)	0.1909
Outpatient office visits	1.7 (1.6–1.8)	2.0 (1.8–2.1)	0.30 (0.08, 0.46)	0.0059
Other outpatient visits	3.0 (2.7–3.2)	2.6 (2.4–2.8)	−0.40 (–0.68, –0.05)	0.0220

Abbreviations. CI, confidence interval; ER, emergency room; PPPM, per patient per month.

Table 3. Adjusted healthcare costs among the cohort of patients treated with afatinib and erlotinib.

All-cause healthcare costs PPPM	Erlotinib (n = 525); mean (95% CI)	Afatinib (n = 525); mean (95% CI)	Mean difference (95% CI)	p-value
Inpatient costs	$2,957 ($2,421–$3,493)	$2,799 ($1,913–$3,685)	−$158 (–1,192.20, 876.79)	0.7648
Outpatient ER costs	$258 ($186–$329)	$271 ($171–$372)	$14 (–109.10, 136.81)	0.825
Outpatient office costs	$1,070 ($829–$1,312)	$1,624 ($1,289–$1,958)	$553 (140.92, 965.35)	0.0086
Other outpatient costs	$4,195 ($3,560–$4,830)	$3,570 ($3,057–$4,082)	−$625 (–1,439.81, 189.88)	0.1326
Pharmacy costs	$5,932 ($5,669–$6,196)	$6,709 ($6,458–$6,959)	$776 (413.15, 1,139.16)	<0.0001
Total medical (inpatient + outpatient) costs	$8,479 ($7,602–$9,356)	$8,264 ($7,131–$9,396)	−$216 (–1,646.58, 1,215.21)	0.7674
Total (inpatient + outpatient + pharmacy) costs	$14,412 ($13,534–$15,289)	$14,972 ($13,843–$16,102)	$560 (–868.09, 1,989.03)	0.4415

Abbreviations. CI, confidence interval; ER, emergency room; PPPM, per patient per month; SD, standard deviation.