Claims Analysis Research Articles

Multi-level factors linked to young adult primary care transitions: evidence from a state all-payer claims analysis

ObjectiveDelayed transitions from pediatric to adult primary care leads to gaps in medical care. State all-payer claims data was used to assess multilevel factors associated with timely transition from pediatric to adult primary care.Materials and methodsWe created a cohort of 4,320 patients aged 17–20 in 2014–2017 continuously enrolled in health insurance 36 months between 2014 and 2019 and attributed to a pediatric provider in months 1–12. We also constructed primary care provider networks identifying links between providers who saw members of the same family. Logistic regression was used to predict adult primary care in months 25–36 on family, provider, and county-level factors. Finally, we modeled the effect of county and network cluster membership on care transitions.ResultsMale sex, having another family member seeing a pediatrician, and residing in a county with high pediatric care capacity or low adult primary care capacity were associated with lower odds of adult primary care transition.DiscussionWe investigated factors associated with successful transitions from pediatric to adult primary care. Family ties to a pediatrician and robust county capacity to provide primary care to children were associated with non-transition to adult primary care.ConclusionMultiple level factors contribute to non-transition to adult primary care. Understanding the factors associated with appropriate transition can help inform state and national policy.

The shift to authenticity: a framework for analysis of political truth claims

Abstract It is often claimed that political disinformation is more abundant than ever, that populists are particularly prone to lying, and that we live in an era of post-truth or epistemic relativism. Contrary to these views, we interpret this historical trend as a shift from objective to authentic forms of political truth claims. We develop a diagnostic framework that captures different types of political truth claims and their distinct elements. This framework enables interrogation and understanding of the current state of epistemic contestation and change. The rise of both populist and deliberative approaches to democracy, which we use as key examples, are indicators of a gradual shift towards a greater importance of authenticity in the public sphere. We nuance this proposition by distinguishing between different forms of authenticity employed by populist and deliberative politics: communicative authenticity in deliberative politics and original and personal authenticity in populist politics.

EE326 Health Care Resource Utilization and Costs Among Patients with Paroxysmal Nocturnal Hemoglobinuria Initiating Eculizumab and Ravulizumab: A U.S. Claims Analysis

EE326 Health Care Resource Utilization and Costs Among Patients with Paroxysmal Nocturnal Hemoglobinuria Initiating Eculizumab and Ravulizumab: A U.S. Claims Analysis

EPH181 Real World Retrospective Analysis of Short-Term Disability Claims for the Genitourinary System in the United States

EPH181 Real World Retrospective Analysis of Short-Term Disability Claims for the Genitourinary System in the United States

RWD48 Economic Burden Associated With Sobriety Restrictions to Direct-Acting Antiviral Access Among Medicaid Patients With Hepatitis C Virus: A Retrospective Analysis of Claims from States With and Without Restrictions

RWD48 Economic Burden Associated With Sobriety Restrictions to Direct-Acting Antiviral Access Among Medicaid Patients With Hepatitis C Virus: A Retrospective Analysis of Claims from States With and Without Restrictions

EE251 Effect of Anticholinergic Burden on Healthcare Costs in Patients With Overactive Bladder: A Retrospective Database Claims Analysis

EE251 Effect of Anticholinergic Burden on Healthcare Costs in Patients With Overactive Bladder: A Retrospective Database Claims Analysis

CO52 Treatment History, Healthcare Resource Use, and Costs Among Patients With Pulmonary Arterial Hypertension (PAH) Initiating Treatment With Macitentan: A Retrospective Claims Analysis

CO52 Treatment History, Healthcare Resource Use, and Costs Among Patients With Pulmonary Arterial Hypertension (PAH) Initiating Treatment With Macitentan: A Retrospective Claims Analysis

MSR65 The Benefits of a Complex Identification and Stratification Model for Depression: Insights from a Large Claims Analysis Study

MSR65 The Benefits of a Complex Identification and Stratification Model for Depression: Insights from a Large Claims Analysis Study

RWD114 Economic Burden, Treatment Utilization, and Medication Adherence of Post-Traumatic Stress Disorder (PTSD) Patients: A Retrospective Commercial and Medicare Part B Insurance Claims Analysis

RWD114 Economic Burden, Treatment Utilization, and Medication Adherence of Post-Traumatic Stress Disorder (PTSD) Patients: A Retrospective Commercial and Medicare Part B Insurance Claims Analysis

A retrospective claims analysis of US pediatricians prescribing practices for the treatment of Molluscum Contagiosum

Introduction: Molluscum Contagiosum (MC), a common viral skin infection affects mostly children, is caused by Molluscipoxvirus. MC is characterized by flesh-colored, round, dome-shaped, umbilicated bumps. Pediatricians are often the first to diagnose MC. Objective: To examine US pediatrician’s MC treatment management using claims data. Methods: Syneos used the Compile Claims database to collect all medical and pharmacy claims for pediatric patients diagnosed with molluscum (ICD10 Code B081) in 2019-2020. Pediatric patients with a Molluscum (B081) claim from a pediatrician practice were calculated along with patients prescribed a prescription by the same pediatrician within 30 days of a molluscum claim. Practitioners were categorized as “wait and see,” “treater” or “referrer.” Frequency data were captured. Results: From 2019-2020, 260,788 molluscum patients ≤ 19 years were diagnosed by 56,026 healthcare providers. Pediatricians were responsible for a majority of molluscum diagnoses: 72% of patients (187,228) diagnosed by 35,017 pediatricians. Most pediatricians initially managed MC with a “wait and see” approach (91%). If a “wait and see” pediatrician initiated treatment, half managed by prescription, whereas “treaters” used in-office procedures (81%) and prescriptions (23%). Mupirocin (45%) and triamcinolone (23%) were preferred prescriptions. Conclusion: Mupirocin and triamcinolone were likely used to treat signs of inflammation indicative of MC resolution known as Beginning of the End (BOTE) sign. Neither are FDA approved for MC nor antiviral; mupirocin use without secondary bacterial infection may contribute to resistance. Newly approved MC indicated therapies should be considered and a better understanding of BOTE is essential to distinguish MC resolution from secondary infection.

Claims-based analysis of treatment practices of patients with metastatic gastroenteropancreatic neuroendocrine tumors (mGEP-NET) in the USA.

e16286 Background: GEP-NET is a rare disease with variable tumor biology. An indolent disease course with subtle symptoms renders timely diagnosis difficult; 2/3 of patients (pts) are diagnosed at locally advanced or metastasized stage. In clinical decision-making, disease-specific factors, patient (pt) age and long-term disease control must be balanced against the aggressiveness of therapies. NCCN, NANETS and ENETS guidelines recognize the diversity of mGEP-NET by recommending individualized treatment approaches. We aimed to describe treatment (Tx) utilization patterns in mGEP-NET. Methods: Retrospective cohort study using MarketScan® Commercial and Medicare Databases spanning 07/01/2017-01/31/2023. Eligible were GEP-NET pts with ≥1 inpatient or ≥2 outpatient claims, a subsequent new diagnosis of metastatic disease (index), no secondary malignancy, and follow-up time of ≥12 months (m) after index. Results: Of 16218 GEP-NET pts, 2002 (mean age 60y; 50% female) met inclusion criteria. Mean follow-up time after index was 17m, with 49%, 27% and 15% followed up for ≥12, 24 and 36m, resp. Medical history (12m baseline before index) included mean Charlson Comorbidity Index of 2.62, with hypertension (HTN), type 2 diabetes (T2DM), chronic liver disease (CLD), asthma/COPD, cardiovascular disease (CVD), and chronic kidney disease (CKD) present in 56, 26, 22, 18, 17 and 10% of pts, resp.; 5% had carcinoid syndrome. In total, 949 pts (47.4%) received first-line (1L) systemic Tx: somatostatin analogs (SSA; 61.6%) of either very short or long duration (median 116d vs 775d), chemotherapy (38.8%), targeted therapies (3.4%) and PRRT (0.5%). Relative to NCCN cancer surveillance guidelines, 49.5% received more and 36.8% received fewer than 4 scans in the first year of treatment. Conversely, 1053 (52.6%) did not receive any 1L systemic Tx. With the exception of CLD, pts with vs without 1L Tx had similar proportions of medical conditions during the 12m baseline and during follow-up (HTN 72.4 vs 66.5%; T2DM 34.0 vs 30.3%; asthma/COPD 16.5 vs 19.3%; CVD 27.3 vs 36.9%; CKD 18.9 vs 17.9%; however, CLD 54.0 vs 36.7%). See Table comparing both cohorts on insurance, treatments, and health care utilization during follow-up. Conclusions: This claims analysis reveals treatment differences among mGEP-NET pts that cannot be explained by the parameters assessed herein. Further research should investigate factors influencing diagnosis and treatment decision-making, applying also pt-level health record data; and analyze economic barriers to diagnosis and treatment. [Table: see text]

FRI-383 Unique characteristics and risk of liver-related events among individuals with hepatitis D virus infection with and without concurrent hepatitis C virus infection: a United States administrative claims analysis

FRI-383 Unique characteristics and risk of liver-related events among individuals with hepatitis D virus infection with and without concurrent hepatitis C virus infection: a United States administrative claims analysis

Adherence and Persistence Among Risdiplam-Treated Individuals with Spinal Muscular Atrophy: A Retrospective Claims Analysis.

Spinal muscular atrophy (SMA) is a neuromuscular disease caused by deletions and/or mutations in the survival of motor neuron1 (SMN1) gene. Risdiplam, the first and only oral SMN2 pre-mRNA splicing modifier, is US Food and Drug Administration-approved for the treatment of pediatric and adult patients with SMA. For patients with SMA, long-term adherence to and persistence with an SMA treatment may be important for achieving maximum clinical benefits. However, real-world evidence on patient adherence to and persistence with risdiplam is limited. This retrospective study examined real-worldadherence and persistence with risdiplamfrom a specialty pharmacy in patients with SMA over a 12-month period. Adherence was estimated by using proportion of days covered (PDC) and was calculated over variable (time between first and last fill) and fixed (time from first fill to study period end) intervals. Persistence was defined as no gap in supply ≥ 90days. Patients were included if the time between the index date and study observation period was ≥ 12months, if they initiated risdiplam between August 2020 and September 2022, received ≥ 2 risdiplam fills, and had an SMA diagnosis associated with a risdiplam fill. Subgroup analyses of risdiplam adherence and persistence were performed by age and primary payer type. The proportion of patients (N = 1636) adherent at 12months based on variable and fixed interval PDC was 93% and 79%, respectively. Adherence was high among patients on commercial insurance, Medicaid, or Medicare (range 86-96%). Mean persistence was 330.4days. The highest proportion of patients who were persistent were on Medicaid (81%). These findings demonstrate that patient adherence to and persistence with risdiplam treatment were high, including across all subgroups tested.

Single institution retrospective review of patients with metastatic hormone receptor positive breast cancer receiving first line therapy of CDK4/6 inhibitors.

e13090 Background: Breast cancer continues to be the most commonly diagnosed cancer in women. The majority of these cancers are estrogen positive (ER+) and about 6% of new cases are stage 4 at time of diagnosis. The current standard of care for postmenopausal women with stage 4 ER+ breast cancer is a combination of an aromatase inhibitor (AI) with a cyclin-dependent kinase (CDK) 4/6 inhibitor. Based on Medicare data claim analysis from IQVIA, CDK 4/6 inhibitors are being used nationally in the first line setting in 56% of cases where 24% of cases were treated with AI monotherapy. The state of Kentucky currently lies below this national average by using this treatment regimen in 38% of cases where 47% of cases are treated with AI monotherapy. The reason for this discrepancy between the national average and Kentucky is currently unknown. To further understanding, we have conducted an internal review of adherence to the guidelines. Methods: This is a single center retrospective study done at University of Louisville, Brown Cancer Center. Data was collected on patients who had biopsy proven metastatic hormone positive breast cancer from July 2021 until May 2023 (n=41). Collected characteristics include age on diagnosis, tumor grade, sites of metastatic disease, first line treatment received, choice of CDK4/6 inhibitor if received, and prior exposure to chemotherapy or anti-estrogen therapy. Results: In our cohort of 41 patients, we found that 63.4% (n=26) of patients received an AI and CDK4/6 inhibitor in the first line. There were 4.88% (n=2) of patients who received AI monotherapy, 21.9% (n=9) received Fulvestrant and CDK4/6 inhibitor, 4.88 % (n=2) received AI and Fulvestrant and 4.88% (n=2) received Fulvestrant alone. In total, patients who received estrogen therapy plus CDK4/6 inhibitor totaled 85% of new patients (n=35). Conclusions: This internal review showed our institution to be compliant with endocrine therapy and CDK 4/6 inhibitor in front-line treatment for the majority of metastatic ER+ patients. Given the supportive data for use of CDK 4/6 inhibitors in front-line treatment, the compliance is expected to be much higher. We recommend continued discussion amongst oncology providers to help identify barriers to treatment and determine the causes for poor compliance in the state of Kentucky.

Impact of Anti-Discrimination Legislation on Access to Gender-affirming Care: A Commercial Claims Analysis

ObjectivesTo examine the temporal relationship between the anti-discrimination rules of the Affordable Care Act, which took full effect in 2017, and the incidence of commercial claims for gender-affirming care, as well as cost sharing for these services. MethodsWe used a previously described algorithm to define a cohort of gender diverse adults in the MarketScan® Commercial Claims and Encounters Database. Claims for gender-affirming medical and surgical care were identified using International Classification of Diseases and Current Procedural Terminology codes plus pharmacy data; the annual incidence of surgical claims was calculated. Interrupted time series analyses were used to evaluate the temporal relationship between claims and anti-discrimination legislation. Claims data was also used to evaluate the patient contribution towards services. ResultsThere were 70,733 gender diverse adults included in the study and 36,702 (51.9%) of them filed claims for gender-affirming care. The incidence of persons with claims for gender-affirming surgery increased from 0.002% in 2009 to 0.012% in 2021. Interrupted time series analyses demonstrated a greater year-to-year increase for claims after anti-discrimination policy influences took effect. This change was greatest for transmasculine chest procedures. The median lifetime net payment for gender-affirming surgery was $12,429.10 and cost sharing was $1,019.20 (8.6%). ConclusionsCommercial claims for gender-affirming surgery increased temporally with respect to implementation of anti-discrimination legislation and cost-sharing was reasonably low. However, many gender diverse persons did not have claims for gender-affirming care, which may indicate continued out-of-pocket payment for these services.

A question of truth: accusations of untruthfulness by populist and non-populist politicians on Facebook during the COVID-19 crisis

ABSTRACT Online environments can foster opportunities for political engagement but can also hinder democratic deliberation by promoting hostile and polarizing communication. A prominent concern revolves around the attacks on political actors’ truthfulness in public discourse. Such discourse is expressed through anti-elite and antagonistic attacks on perceived (un)truthfulness employed by some politicians toward political opponents in public debates, and it is argued to maintain a close affinity with populist politics. During crises, when people seek guidance from elites, discourses of untruthfulness can lead to further uncertainty by eroding trust in political leadership. Relying on the extensive claims analysis of 7,109 Facebook posts published by political party leaders between March 2020 and February 2021, this study investigates how accusations of untruthfulness unfold in the social media posts of populist and non-populist political leaders in Austria, the Czech Republic, Germany, and Poland during the COVID-19 pandemic. Our findings show that populist leaders are generally more prone to utilize accusations of untruthfulness in their social media posts than non-populist politicians, but the extent of attacks is context-dependent.

Collaborative artificial intelligence system for investigation of healthcare claims compliance

Healthcare fraud, waste and abuse are costly problems that have huge impact on society. Traditional approaches to identify non-compliant claims rely on auditing strategies requiring trained professionals, or on machine learning methods requiring labelled data and possibly lacking interpretability. We present Clais, a collaborative artificial intelligence system for claims analysis. Clais automatically extracts human-interpretable rules from healthcare policy documents (0.72 F1-score), and it enables professionals to edit and validate the extracted rules through an intuitive user interface. Clais executes the rules on claim records to identify non-compliance: on this task Clais significantly outperforms two baseline machine learning models, and its median F1-score is 1.0 (IQR = 0.83 to 1.0) when executing the extracted rules, and 1.0 (IQR = 1.0 to 1.0) when executing the same rules after human curation. Professionals confirm through a user study the usefulness of Clais in making their workflow simpler and more effective.

#2018 Characteristics of patients with complement 3 glomerulopathy (C3G): a retrospective linked electronic medical record (EMR) and claims analysis

Abstract Background and Aims C3G is characterised by C3 deposition in the glomeruli, caused by dysregulation of the alternative complement pathway. Contemporary datasets on the clinical burden of patients with C3G in the United States (US) are limited. The aim of this analysis was to describe the demographics and clinical characteristics of patients diagnosed with C3G in the US. Methods This was a retrospective cohort analysis of patients with C3G included in the US HealthVerity database with an EMR and linked pharmacy and medical claims data, who were diagnosed between January 1, 2017 and March 31, 2022 and aged ≥12 years at diagnosis. The index date was the date of the first C3G diagnosis, identified by International Classification of Diseases 10th Revision Clinical Modification (ICD-10-CM) and Systematized Nomenclature of Medicine (SNOMED) diagnosis codes. Included patients had database records for ≥12 months before the index date (the baseline period). Patients aged ≥50 years with monoclonal gammopathy of unknown significance (MGUS) were excluded. Patient demographic and clinical characteristic data for the overall population, and stratified by transplant status, were summarised with descriptive statistics. Results Overall, 2021 patients had ≥1 diagnosis of C3G in the US HealthVerity database during the identification period. Of these, 1060 patients did not meet the criteria for the analysis, including 44 patients (2.2%) who were excluded due to the presence of a diagnostic code for MGUS at ≥50 years of age. The final cohort included 961 patients, of whom 62.4% were female. At the index date, mean (standard deviation [SD]) age was 44.4 (19.6) years (Table 1); 80 patients (8.3%) were aged <18 years, 881 (91.7%) were aged ≥18 years, and 156 (16.2%) were aged ≥65 years. Median (lower quartile [Q1], upper quartile [Q3]) database history was 41.7 (25.9, 66.8) months, and mean (SD) follow-up time from the index date was 22.7 months (16.4). Comorbidities recorded during the baseline period included hypertension (57.4%), type II diabetes (25.1%), and congestive heart failure (12.9%). Among patients who were aged ≥65 years vs <65 years at the index date, the proportion of patients with hypertension (93.6% vs 50.4%), type II diabetes (52.6% vs 19.8%), and congestive heart failure (32.1% vs 9.2%) were numerically higher. Of 461 patients (48.0%) with a known chronic kidney disease stage, 282 (61.2%) had stage 3–5 chronic kidney disease during the baseline period. Baseline estimated glomerular filtration rate (eGFR) data were available for 205 patients (21.3%); overall, median (Q1, Q3) eGFR values were 82.0 (48.0, 107.0) mL/min/1.73 m2, and 56.6% of patients had an eGFR value of <90 mL/min/1.73 m2. Among 78 patients (8.1%) with proteinuria data during the baseline period, median (Q1, Q3) proteinuria levels were 1.4 (0.3, 3.3) g/g, and 44 patients (56.4%) had a proteinuria level ≥1.0 g/g. Extrarenal manifestations including ocular haemorrhage/retinal occlusion, pulmonary haemorrhage, ocular drusen, and acquired partial lipodystrophy were recorded in 1.7%, 0.9%, 0.5%, and 0.1% of patients, respectively. Overall, 19 patients (2.0%) had previously undergone a kidney transplant; the proportion who had hypertension, type II diabetes, or congestive heart failure during the baseline period was 89.5%, 31.6%, and 10.5%, respectively. Baseline eGFR data were available for 4 patients (21.1%) who had previously received a kidney transplant (Table 1). Conclusions This contemporary assessment of patients with C3G, using real-world EMR and administrative claims data from a national US cohort, showed that comorbidities around the time of C3G diagnosis were common. Among patients with available eGFR data, the majority exhibited reduced kidney function during the baseline period.

#2066 Treatment patterns of patients with complement 3 glomerulopathy (C3G): a retrospective linked electronic medical record (EMR) and claims analysis

Abstract Background and Aims C3G is characterised by C3 deposition in the glomeruli, caused by dysregulation of the alternative complement pathway. Currently, there are no approved therapies for C3G. The aim of this analysis was to evaluate treatment patterns in patients with C3G in the United States (US). Methods This was a retrospective cohort study of patients with C3G, with an EMR and linked pharmacy and medical claims data in the US HealthVerity database, who were diagnosed between Jan 1, 2017 and Sep 30, 2021 and aged ≥12 years at diagnosis. Included patients had database records for ≥12 months before (baseline period) and after (follow-up period) the index date (date of first C3G diagnosis, identified by International Classification of Diseases 10th Revision Clinical Modification [ICD-10-CM] and Systematized Nomenclature of Medicine [SNOMED] diagnosis codes). Endpoints included: proportion of patients receiving a treatment, including supportive care (angiotensin-converting enzyme inhibitors [ACEi]/angiotensin II receptor blockers [ARB]), immunosuppressants (IM; including corticosteroids [CS]/glucocorticoids [GC] and mycophenolate mofetil [MMF]), and eculizumab; proportion of patients discontinuing treatment; and duration of treatment. Discontinuing treatment was defined as the absence of a subsequent claim for medication for ≥60 days. Results were assessed using descriptive statistics and analysed by Fisher's exact test, Mann–Whitney U test, or Student's t-test, as appropriate. Results The final cohort included 683 patients. Overall, 346 (50.7%) patients had ≥1 treatment record for C3G during follow-up (median follow-up 24.0 months; median time from index to first treatment 1.1 months). Mean age (standard deviation) of treated and untreated patients was 47.7 (19.4) and 39.6 (18.0) years (P < 0.0001), respectively; 54.3% of treated patients and 72.7% of untreated patients were female (P < 0.0001). Comorbidities reported in treated and untreated patients, respectively, included: hypertension (75.1% and 33.5%; P < 0.0001) and type II diabetes (34.7% and 12.8%; P < 0.0001). Baseline proteinuria data were available for 39 (11.3%) treated patients and 11 (3.3%) untreated patients (P < 0.0001). Median (lower quartile, upper quartile) proteinuria levels were 1.9 (0.7, 3.3) g/g and 0.2 (0.1, 2.3) g/g for the treated and untreated populations, respectively (P = 0.05). Among treated patients (n = 346), most (76.0%) received an ACEi/ARB alone in the first line, 14.2% received IM alone, and 5.8% received concomitant ACEi/ARB and IM (Table 1). A small number of remaining patients received a sodium-glucose cotransporter-2 inhibitor (SGLT2i) ± ACEi/ARB (2.9%), or eculizumab ± IM (1.2%). Less than half of treated patients (43.9%) received second-line therapy, and 17.6%, 6.6%, and 2.0%, respectively, received subsequent lines of treatment. Among treated patients, the most common treatment sequence was ACEi/ARB alone in the first line, without subsequent lines of therapy (42.2%); 30.9% of treated patients received IM (alone or in combination with other treatments) at any time during follow-up. Median duration of treatment in months (95% confidence interval) in any line was 14.9 (9.9, 18.4) for ARB, 8.6 (7.5, 11.1) for ACEi, 7.4 (3.3, 22.6) for SGLT2i, 4.7 (3.0, 6.6) for MMF, and 1.0 (0.9, 3.0) for CS/GC. During follow-up, 225 (65.0%) patients discontinued treatment: 22 (9.8%) and 203 (90.2%) patients restarted and did not restart therapy, respectively. Conclusions These real-world data show that only half of patients with C3G had a record of treatment during follow-up. Compared with the untreated population, patients who received treatment were older, more likely to be male, and more likely to have hypertension or type II diabetes. Among treated patients, the most common treatment sequence was supportive care with an ACEi/ARB alone, and less than one-third received IM at any time during follow-up. Use of the complement inhibitor, eculizumab, was low in this population. A large proportion of patients discontinued treatment during follow-up; given the progressive nature of C3G, these data may highlight the need for novel therapies in the treatment of C3G.

Chemotherapy-induced febrile neutropenia (FN): healthcare resource utilization (HCRU) and costs in commercially insured patients in the US

PurposeFebrile neutropenia (FN) is a known side effect of chemotherapy, often requiring hospitalization. Economic burden increases with an FN episode and estimates of cost per episode should be updated from real-world data.MethodsA retrospective claims analysis of FN episodes in patients with non-myeloid malignancies from 2014 to 2021 was performed in IQVIA PharMetrics® Plus database. FN episodes were defined as having same-day claims for neutropenia and fever or infection, plus antibiotic in outpatient settings, following a claim for chemotherapy; index date was defined as the first claim for neutropenia/fever/infection. Patients receiving bone marrow/stem cell transplant and CAR-T therapy were excluded, as were select hematologic malignancies or COVID-19. Healthcare utilization and costs were evaluated and described overall, by episode type (w/wo hospitalization), index year, malignancy type, NCI comorbidity score, and age group.Results7,033 FN episodes were identified from 6,825 patients. Most episodes had a hospitalization (91.2%) and 86% of patients had ≥1 risk factor for FN. Overall, FN episodes had a mean (SD) FN-related cost of $25,176 ($39,943). Episodes with hospitalization had higher average FN-related costs versus those without hospitalization ($26,868 vs $7,738), and costs increased with comorbidity score (NCI=0: $23,095; NCI >0-2: $26,084; NCI ≥2: $26,851).ConclusionsFN continues to be associated with significant economic burden, and varied by cancer type, comorbidity burden, and age. In this analysis, most FN episodes were not preceded by GCSF prophylaxis. The results of this study highlight the opportunity to utilize GCSF in appropriate oncology scenarios.