Abstract
584 Background: Colorectal cancer patients with EGFRI therapies may develop dermatologic ADRs. ADRs negatively affect patients’ quality of life, require medical care, and may lead to a substantial economic burden. The objective of this study is to assess the economic burden of dermatologic ADRs in patients with colorectal cancer (CRC). Methods: Continuously enrolled adult patients with ≥ 1 CRC diagnosis initiated on an FDA-approved EGFRI therapy (i.e., cetuximab, panitumumab) were selected from a large US claims dataset. Patients were classified into two mutually exclusive cohorts depending on whether or not they had dermatologic ADR during the period following EGFRI initiation. Dermatologic ADRs were identified using ICD-9-CM codes. Patients were observed from the index date up to the end of the health plan enrollment, or data availability, or 90 days after the EGFRI discontinuation, whichever occurred first. Incidence rate ratios (IRRs) for healthcare resource utilization were estimated using Poisson regression models. Incremental costs (2010 USD) were estimated on a monthly basis using generalized linear or two-part models. Multivariate regressions controlled for age, gender, comorbidities, and baseline healthcare utilization and costs. Results: A total of 746 and 1,720 patients were included in the dermatologic ADR and ADR-free cohorts, respectively. After adjusting for confounding factors, compared to patients in the ADR-free cohort, patients in the ADR cohort had higher incidence of emergency room visits (IRR=1.2; p=.009) and higher incidence of outpatient visits (IRR=1.13; p<.001). Moreover, patients in the ADR cohort incurred higher total healthcare costs by $2,532 (p=.009) per patient per month mainly due to higher emergency care costs by $566 (p<.001). Conclusions: Compared to ADR-free patients, dermatologic ADR patients with colorectal cancer incurred a substantial economic burden related to higher healthcare resource utilization and costs. Efforts to improve the dermatologic side effect profile of EGFRI are needed to control this burden.
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