Real-world healthcare costs amongst non-small cell lung cancer (NSCLC) patients tested with a host immune classifier (HIC).

Abstract

e21187 Background: The HIC is a proteomic test that measures immune response in patients diagnosed with NSCLC. The blood based HIC stratifies patients into two groups, HIC-H and HIC-C which helps evaluate the patient’s prognosis and response to treatment. Currently, no real-world studies have described healthcare costs amongst patients tested with the HIC. This subset analysis of HIC claims examined costs among patients with NSCLC prior to and after using the HIC proteomic test. Methods: HIC test results were retrospectively queried using MarketScan Commercial and Medicare Supplemental Databases using data between January 1, 2016 to June 30, 2021 linked to Biodesix data files. Patients were included if they were age 18 and older on index date (date of HIC testing), underwent a HIC proteomic test, were continuously enrolled in the MarketScan database for the 6-months before index (pre-index period) and one month post-index, and had at least one non-diagnostic medical claim of lung cancer during the pre-index period. Healthcare costs were measured per patient per month (PPPM) during the pre-index and post-index period and compared between HIC-H and HIC-C cohorts. All-cause healthcare costs analyzed included inpatient costs, outpatient costs, outpatient pharmacy costs, total medical costs (inpatient + outpatient), and total costs (total medical + outpatient pharmacy). Results: Of the 328 included patients, 260 patients were HIC-H and 68 were HIC-C. On index, 178 patients had non-metastatic lung cancer and 150 patients had metastatic lung cancer. When examining healthcare costs prior to HIC testing, total costs and inpatient costs were higher amongst HIC-C patients ($10,299 vs $9,689 and $4,032 vs $3,218, respectively) although not statistically significant. HIC-C patients had significantly higher biopsy costs compared to HIC-H patients ($1,285 vs $400, P < 0.05) even though less HIC-C patients underwent a lung biopsy (41% vs 53%, P = 0.091). When assessing healthcare costs post HIC testing, total medical costs were significantly higher in the HIC-C patients ($25,255 vs $17,210, P < 0.05). Although not statistically significant, HIC-C patients had higher inpatient costs and total costs ($9,903 vs $5,583 and $26,237 vs $18,652, respectively). Amongst the patients had significantly higher inpatient costs ($18,580 vs $4,278, P < 0.05), total medical costs ($29,574 vs $12,446, P < 0.05) and total costs ($31,316 vs $13,500, P < 0.05). Conclusions: Patients with NSCLC who are identified as HIC-C have higher healthcare costs, including lung cancer diagnostic and total costs, prior to and post HIC testing. Utilization of the HIC test may help to identify patients who may benefit from additional health system navigation support to mitigate their anticipated increased health care costs.