Components of total cost of care in real-world patients with mPDAC who received first-line FOLFIRINOX or Gem/Abrax.

Abstract

e16282 Background: FOLFIRINOX (FFX) and Gemcitabine/Abraxane (Gem/Abrax) are two recommended options for the treatment of metastatic pancreatic ductal adenocarcinoma (mPDAC). There is limited research assessing differences in costs between real-world patients with mPDAC who received first-line (1L) FFX or Gem/Abrax. Methods: We used ICD-10 diagnosis codes to identify patients aged 65+ with mPDAC without end-stage renal disease in the 2018-2021 Medicare Parts A, B, and D 100% Research Identifiable Files (RIF) data. Total cost of care (TCOC) represents mean Medicare paid amounts and patient cost sharing. Lines of therapy (LOTs) were assigned based on therapies used. LOTs ended the day before a new chemotherapy began, 28 days after the last chemotherapy (if no new chemotherapy), or upon death. Study patients were treated with FFX or Gem/Abrax as a 1L therapy. Results: We identified 8,889 patients with mPDAC that received an 1L FFX regimen between 2018 and 2021 and 15,053 patients that received a Gem/Abrax regimen in the same period. Total cost of care was similar among the two cohorts ($7,187 per administration cycle among patients receiving FFX vs. $7,240 among those receiving Gem/Abrax in 1L). Patients receiving Gem/Abrax had higher chemotherapy costs ($2,980) than FFX ($406), however, patients receiving FFX had higher granulocyte colony-stimulating growth factor costs ($1,592 FFX vs. $293 Gem/Abrax) and higher Other Part B costs ($1,301 FFX vs. $876 Gem/Abrax). Inpatient costs were similar between FFX ($1,732) and Gem/Abrax ($1,615), while outpatient costs were higher for patients receiving FFX ($1,549) than patients receiving Gem/Abrax ($847). Conclusions: Among Medicare Fee-For-Service patients with mPDAC, patients receiving FOLFIRINOX (FFX) or Gemcitabine/Abraxane (Gem/Abrax) as a first-line therapy incurred similar costs of care overall, with different distributions across service categories. While therapy costs were lower among patients receiving generic FFX than those receiving branded Gem/Abrax, higher costs from supportive therapies offset those differences.