Real-world economic outcomes among patients (pts) who initiated sunitinib or pazopanib as first targeted therapy (TT) for advanced renal cell carcinoma (aRCC): A retrospective analysis of Medicare data.

Abstract

475 Background: Evidence on economic outcomes could provide insight on comparative economic benefit of TTs. This study assessed all-cause healthcare resource utilization (HRU) and costs among aRCC patients who initiated pazopanib and sunitinib, two commonly-used first TTs. Methods: Pts with aRCC who initiated sunitinib or pazopanib as first TT (index therapy/index date) were identified in this 100% Medicare data + Part D linkage (1/1/2006-12/31/2014). Characteristics were assessed during the 1 year prior to index date (baseline period) and pts were followed until death, end of eligibility, or end of data (study period), whichever was earliest. Pts were stratified by first TT initiated and 1:1 matched using propensity scores based on age, sex, race, year of RCC diagnosis, metastatic sites, comorbidities, and baseline inpatient, outpatient, emergency room, and pharmacy costs. Study period all-cause HRU and costs (2015 USD) were assessed on a per pt per month (PPPM) basis and compared between the matched cohorts. Results: Before matching, the cohorts were similar in baseline characteristics; however, the pazopanib cohort (n=526) was associated with higher outpatient visits and costs and lower pharmacy costs during the baseline period than the sunitinib cohort (n=1,185; all p<0.05). After matching, all baseline characteristics were balanced (n=522 for both). First TT with pazopanib was associated with significantly lower total healthcare costs ($10,416 vs. $8,845, mean difference [MD]):$1,571, p<0.01), total medical costs ($6,904 vs. $5,460, MD:$1,444, p<0.01), inpatient costs ($4,035 vs. $2,914, MD:$1,120, p<0.01), inpatient admissions (0.26 vs. 0.18, MD:0.08, p<0.01), and inpatient days (1.9 vs. 1.4, MD:0.5, p<0.01) compared with the sunitinib cohort. Conclusions: In this retrospective analysis of Medicare aRCC pts, treatment first line with pazopanib compared to sunitinib had lower follow-up all-cause healthcare costs and resource use, particularly with lower inpatient admissions and shorter length of stay.