Real-world Healthcare Resource Research Articles

P-1566. Healthcare Resource Use and Costs of Acute Uncomplicated Cystitis in Japan

Abstract Background Acute uncomplicated cystitis (AUC) is an area of interest for outpatient antimicrobial stewardship in Japan due to the high prevalence of community antibiotic use. Literature on the cost burden of AUC in Japan is limited. We aimed to quantify real-world healthcare resource utilization (HCRU) and costs of treating AUC in Japan. Methods This retrospective cohort study used Japanese Medical Data Center (JMDC) claims data (1 October 2015−30 November 2021). Eligible patients (≥ 18 to < 75 years) had an outpatient AUC diagnosis claim in the same month as ≥ 1 oral antibiotic prescription (date of prescription = index date). Continuous health plan enrolment, with medical and pharmacy benefits, was required ≥ 12 months pre index (baseline period) and ≥ 12 months post index (follow-up period). Patients with complicated cystitis or pyelonephritis were excluded. The index AUC episode was defined as 28 days from index date and was extended an additional 28 days if treatment failure (TF) was observed (within 28 days from date of TF). Patients were stratified based on evidence of TF or AUC recurrence (full definitions in Table 1). AUC-related costs (Japanese Yen [¥]) and HCRU, per episode, were compared within subgroups. Results Overall, 71,467 patients were included, of whom 3742 (5%) had evidence of TF and 3206 (4%) had recurrent AUC. The mean (standard deviation [SD]) cost of any AUC episode was ¥14,905 (¥31,344) (Table 2), with 1.22 (0.46) outpatient claims and 1.07 (0.27) pharmacy prescription claims per episode (Table 3). Patients with evidence of TF had significantly higher mean (SD) pharmacy (¥2078 [¥2295]) and total costs (¥25,932 [¥64,494]), and a higher number of pharmacy prescription claims (2.03 [0.45]) per episode versus patients without TF (all p< 0.001). Patients with recurrent AUC had higher mean (SD) total costs (¥16,514 [¥35,241]) and higher outpatient claims (1.10 [0.34]) per episode versus patients without recurrence (¥14,830 [¥31,148]) total costs and (¥1037 [¥1281]) outpatient claims; (p=0.008 and p< 0.001, respectively). Conclusion TF rates and recurrence of AUC in Japan were modest; however, the economic burden of AUC was greater in patients who had evidence of TF or recurrence. Disclosures Meg Franklin, PharmaD, PhD, Franklin Pharmaceutical Consulting: Owner and President|Franklin Pharmaceutical Consulting: Ownership Interest|PRECISIONheor (who received funding from GSK to complete this study): Advisor/Consultant Maia R. Emden, BA, PRECISIONheor: Previous employee of PRECISIONheor, who received funding from GSK to complete this study Elise Bauer, MS, PRECISIONheor: Previous employee of PRECISIONheor, who received funding from GSK to complete this study Naomi Sacks, PhD, PRECISIONheor: Previous employee of PRECISIONheor, who received funding from GSK to complete this study Fanny S. Mitrani-Gold, MPH, GSK: Employee|GSK: Stocks/Bonds (Public Company) Shinyoung Ju, MS, GSK: Employee|GSK: Stocks/Bonds (Public Company) Ashish V. Joshi, PhD, GSK: Employee|GSK: Stocks/Bonds (Public Company) Yoshiaki Kawano, MD, PhD, GSK: Employee|GSK: Stocks/Bonds (Public Company) Shinya Kawamatsu, PhD, GSK: Employee|GSK: Stocks/Bonds (Public Company) Madison T. Preib, MPH, GSK: Employee|GSK: Stocks/Bonds (Public Company)

US Real-World Effectiveness, Tolerability, and Healthcare Resource Utilization After Addition of Fremanezumab for Preventive Treatment in Patients Using Gepants for Acute Treatment of Migraine: Results From a Retrospective Chart Review.

Fremanezumab, a monoclonal antibody (mAb) targeting the calcitonin gene-related peptide (CGRP) pathway, and gepants, small molecule CGRP receptor antagonists, are both approved for the treatment of migraine or its symptoms. This study assessed effectiveness, tolerability, and migraine-related healthcare resource utilization (HCRU) after the addition of fremanezumab for preventive migraine treatment in patients using gepants for acute treatment. Data were extracted during a retrospective chart review from electronic medical records from the Dent Neurologic Institute. Eligible patients were≥18years old, using gepants (rimegepant or ubrogepant), who initiated fremanezumab between January 1, 2020, and May 1, 2021 (index date: date of fremanezumab initiation) and continued concomitant use of gepants and fremanezumab for≥1month (post-index; between 7-9months of follow-up). Outcomes included monthly migraine days (MMD), adverse events (AEs), reasons for discontinuation, and migraine-related HCRU. A total of 55 patients [female, 93%; mean (SD) age, 43.5 (13.5) years] met the inclusion criteria. All patients were diagnosed with chronic migraine. Patients had an average (SD) MMD of 15.8 (7.4) at the index date. Average (SE) change in MMD from index date to post-index was -6.5 (1.0) days (p<0.0001). Five patients (9.1%) experienced AEs post-index; no serious AEs (SAEs) were reported. The number of migraine-related medications used decreased from the index date to post-index by a mean of 0.6 for preventive medications (p=0.070), and 0.8 for acute medications (p=0.050). The number of outpatient office-based visits also decreased [mean (SD): 6months pre-index, 5.8 (4.4) vs. 6months post-index, 4.1 (4.0); p<0.0001]. The addition of fremanezumab preventively to gepants for acute migraine treatment was effective, resulted in fewer outpatient office visits, and yielded no SAEs or AEs that were novel to these migraine medication classes.

Real-World Treatment Patterns and Healthcare Resource Use for Patients with Myelofibrosis: Results from the METER Study.

Myelofibrosis (MF) is a myeloproliferative neoplasm that was most commonly treated with hydroxyurea (HU) prior to approval of ruxolitinib (RUX), now the standard of care. Factors that influence changes in MF treatment in real-world settings are not well understood. The METER study (NCT05444972) was a multi-country retrospective chart review of MF treatment patterns, treatment effectiveness, and healthcare resource utilization. Of 997 eligible patients, 65.9% had primary MF, and 11.7% were transfusion-dependent. The median (IQR) time from MF diagnosis to start of initial treatment (index date) was 29 (1-140) days. RUX was the most common first-line (1L) therapy (49.0%), followed by hydroxyurea (40.2%); 48.5% of patients remained on 1L therapy through Week 156. A total of 77 patients underwent allogeneic stem cell transplantation; use of transplantation was uncommon as 1L therapy and increased from 2.2% at Week 24 to 11.0% at Week 156 in patients 70 years of age. Median (95% CI) overall survival was 79.1 (70.8-non-estimable [NE]) months in all patients, 142.3 (74.1-NE) months for non-RUX patients, 77.6 (64.2-85.9) months for RUX 1L patients, and 72.6 (62.0-NE) months for RUX 2L+ patients. Of patients who experienced ≥1 corresponding event during the observational period, the median (IQR) hospital length of stay (LoS) (n=520), intensive care unit LoS (n=71), and number of transfusion events (n=375) were 16 (7-37) days, 5 (2-13) days, and 12 (4-26), respectively. Despite improvements, there was a high degree of hospitalization and transfusion events among these patients in routine practice. NCT05444972.

Real-world healthcare resource utilization of Alzheimer’s disease in the early and advanced stages: A retrospective cohort study

ABSTRACT Aims To compare all-cause and Alzheimer’s disease (AD)-related healthcare resource utilization (HCRU) by cognitive stage. Methods and Materials This retrospective study analyzed insurance claims data linked to electronic health records (01/01/2015-12/31/2021). Patients with ≥1 cognitive assessment (Mini-Mental State Examination or Montreal Cognitive Assessment) and ≥1 medical or pharmacy claim for an AD diagnosis or AD medications were included. Inverse probability of treatment weighting (IPTW) was used to address potential confounding. All-cause and AD-related HCRU were summarized per patient per year (PPPY) and compared between early AD and advanced AD cohorts (defined according to cognitive scores) using generalized linear regression models; adjusted incidence rate ratios (IRRs), and 95% confidence intervals (CI) were reported. Results A total of 193 patients were included (median age: 82 years; 63.2% female), 108 with early AD and 85 with advanced AD, with similar mean follow up. All-cause HCRU, on average, was similar between early AD and advanced AD cohorts (37.4 PPPY and 38.9 encounters PPPY, respectively). For AD-related HCRU, patients with early AD had fewer encounters PPPY, on average, than patients with advanced AD (1.26 and 3.88 encounters, respectively). Following IPTW adjustment, the advanced AD cohort had significantly higher overall AD-related HCRU (IRR: 3.64 [95% CI: 1.96-6.75], p <0.001) and outpatient visits (IRR: 2.76 [95% CI: 1.68-4.54], p <0.001) compared to the early AD cohort. Limitations The relatively small sample size of patients with linked claims and cognitive score data limited the ability to assess contribution of all encounter types to HCRU trends, as well as generalizability to the broader AD population. Conclusions Although all-cause HCRU was similar, patients with advanced AD incurred higher AD-related HCRU compared to patients living with early AD. Further research is needed to determine whether interventions earlier in disease progression can mitigate the AD-related healthcare burden for patients with advanced AD.

HSD82 Real World Patient Journey and Healthcare Resource Utilization of HR+/HER2- Breast Cancer Patients in the Brazilian Private Healthcare System

HSD82 Real World Patient Journey and Healthcare Resource Utilization of HR+/HER2- Breast Cancer Patients in the Brazilian Private Healthcare System

RWD4 Real-World Treatment Patterns, Healthcare Costs, and Healthcare Resource Utilization in Patients in the US With Metastatic Non-Small Cell Lung Cancer Receiving Systemic Anticancer Therapy: A Marketscan Data Analysis

RWD4 Real-World Treatment Patterns, Healthcare Costs, and Healthcare Resource Utilization in Patients in the US With Metastatic Non-Small Cell Lung Cancer Receiving Systemic Anticancer Therapy: A Marketscan Data Analysis

EE275 Real-World Healthcare Resource Utilization and Costs in Patients With Locally Advanced or Metastatic Urothelial Carcinoma in China

EE275 Real-World Healthcare Resource Utilization and Costs in Patients With Locally Advanced or Metastatic Urothelial Carcinoma in China

RWD93 Real-World Healthcare Resource Utilization and Related Costs Associated With Ultrarare Diseases in the Brazilian Private Market

RWD93 Real-World Healthcare Resource Utilization and Related Costs Associated With Ultrarare Diseases in the Brazilian Private Market

RWD137 Real-World Healthcare Resource Utilization and Related Costs Associated With Hypertrophic Cardiomyopathy in the Brazilian Private Market

RWD137 Real-World Healthcare Resource Utilization and Related Costs Associated With Hypertrophic Cardiomyopathy in the Brazilian Private Market

RWD95 Real-World Healthcare Resource Utilization and Related Costs Associated With Cholangiocarcinoma in the Brazilian Private Market

RWD95 Real-World Healthcare Resource Utilization and Related Costs Associated With Cholangiocarcinoma in the Brazilian Private Market

Response to "Real-World Healthcare Resource Utilization, Healthcare Costs, and Injurious Falls Among Elderly Patients with Geographic Atrophy" [Letter

Response to "Real-World Healthcare Resource Utilization, Healthcare Costs, and Injurious Falls Among Elderly Patients with Geographic Atrophy" [Letter

RWD54 Real-World Healthcare Resource Utilization and Related Costs Associated With Rare Disease in the Brazilian Private Market

RWD54 Real-World Healthcare Resource Utilization and Related Costs Associated With Rare Disease in the Brazilian Private Market

Real-World Healthcare Resource Utilization, Healthcare Costs, and Injurious Falls Among Elderly Patients with Geographic Atrophy.

This study assessed the clinical and economic burden of geographic atrophy (GA) using real-world data from elderly patients with Medicare Advantage plans in the United States. A retrospective cohort design of patients with GA only, GA + visual impairment (GA + VI), GA + blindness (GA + B), and patients without GA were identified using administrative healthcare claims data from Optum Clinformatics Data Mart. Inverse probability of treatment weighting controlled for confounding when comparing patients with GA only vs without GA, GA + VI vs GA only, and GA + B vs GA only. Endpoints included all-cause and ophthalmic condition-related healthcare resource utilization (HRU), injurious falls, and healthcare costs. HRU and injurious falls were assessed per-person-per-year and per 100 person-years, respectively. Cohorts were compared using rate ratios, 95% confidence intervals (CIs), and p-values from weighted Poisson regression models. Healthcare costs were evaluated per-person-per-year using mean cost differences, 95% CIs, and p-values from weighted linear regression. The study included 18,119 patients with GA only, 2,285 with GA + VI, 1,716 with GA + B, and 72,476 patients without GA. Higher rates of all-cause hospitalizations (RR [95% CI]: 1.08 [1.03, 1.12]), outpatient visits (1.08 [1.05, 1.10]), other visits (1.14 [1.08, 1.21]), and falls with head injuries (1.24 [1.05, 1.45]) were observed in patients with GA vs without GA (P<0.05). GA was associated with higher annual all-cause total healthcare costs, spending an average of $1,171 more after adjustment (P<0.05). Progression to GA + VI and GA + B was associated with a more pronounced burden. The clinical and economic burden of GA is substantial and escalates as the disease advances. These findings suggest early intervention aimed at slowing GA progression may help to mitigate the healthcare burden associated with advancement of GA to visual impairment and blindness.

Real-World Clinical and Healthcare Resource Burden Among Burosumab-Naïve Patients With Familial Hypophosphatemia.

To examine the real-world clinical and healthcare resource burden of familial hypophosphatemia (FH). In a retrospective, observational cohort study using MarketScan claims data from 2017 to 2021, clinical characteristics and healthcare resource utilization (HCRU) and costs were compared between burosumab-naïve pediatric and adult patients with ≥ 1 FH diagnosis code and matched controls without FH. Patient characteristics were evaluated at baseline, and disease characteristics, HCRU, and costs were evaluated over a 12-month follow-up period. Outcomes were analyzed descriptively. Costs were additionally analyzed using multivariate regression models. Overall, 570 patients with FH and 1710 non-FH matched controls were included. Approximately 10% of study participants were aged < 18 years. Patients with FH had 7.8-fold higher mean baseline comorbidity (Charlson Comorbidity Index). The prevalence of morbidities over the 12-month follow-up period was higher in patients with FH than controls, including renal disease (33% vs 3%), arthralgia (25% vs 10%), osteoarthritis (17% vs 6%), and delayed growth/walking difficulty (16% vs 2%; all P < .001). All-cause HCRU was significantly greater for patients with FH than controls over follow-up, including the proportion of patients with at least one inpatient admission (60% vs 4%), outpatient emergency room visit (52% vs 16%), and outpatient pharmacy prescription (96% vs 71%; all P < .001). The mean annual total healthcare cost per patient was also 22.6-fold higher for patients with FH than controls (adjusted cost difference = $129 643; P < .001). Differences were apparent across all age groups. Compared with non-FH matched controls, burosumab-naïve patients with FH experienced multiple morbidities and had substantially higher HCRU and costs.

Real world comparison of filgrastim to filgrastim-sndz in patients with chemotherapy-induced neutropenia.

There exists some apprehension by prescribers, healthcare providers, and other stakeholders regarding the real-world safety and effectiveness of biosimilars. While some of the apprehension is likely due to clinician knowledge gaps in the biosimilarity exercise, additional data (including those generated from the real-world) regarding safety and efficacy could reduce a clinician's perception of biosimilar uncertainty and can potentially increase biosimilar acceptance and uptake. The published literature is lacking regarding the real-world impact on healthcare costs and clinical outcomes when a single healthcare institution converts from filgrastim to filgrastim-sndz as its short-acting Granulocyte Colony Stimulating Factor (GCSF), especially within diverse populations and indications not explicitly studied through the registration trials. Specifically, both filgrastim and filgrastim-sndz possess FDA-approved indications within patients with hematologic malignancies receiving high-dose chemotherapy and in those undergoing bone marrow transplantation. As a biosimilar to filgrastim, the FDA did not require prospective, randomized controlled trials to obtain these indications for filgrastim-sndz. The purpose of this study is to describe real-world healthcare resource costs, utilization patterns, and clinical outcomes in patients with hematologic malignancies who received filgrastim-sndz or filgrastim to support neutrophil recovery following chemotherapy (i.e., induction or consolidation) or a bone marrow transplant (BMT) at Yale New Haven Hospital (YNHH). A total of 148 patients were identified and met the following criteria: at least 18 years old, Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2, absence of fever or infection, newly diagnosed acute myeloid leukemia or newly post-bone marrow transplant and received filgrastim-sndz (Zarxio®) or reference filgrastim (Neupogen®). Healthcare resource utilization outcomes were compared between biosimilar and reference filgrastim using descriptive statistics. There were no major differences between either cohort, including duration of hospitalization, the number of overall emergency room visits and additional hospital admissions with a primary diagnosis of febrile neutropenia or neutropenia within 30 days post-discharge from initial hospital admission, time to neutrophil recovery following GCSF support, and the incidence and duration of both fever and febrile neutropenia. The total cost based on treatment of all patients in each arm differed significantly with filgrastim-sndz being the most cost-effective choice. filgrastim-sndz significantly reduced healthcare utilization costs compared to reference filgrastim with similar effect on absolute neutrophil count, incidence of fever, and febrile neutropenia.

Real-world clinical and economic impacts of delayed rotator cuff repair surgery in Japan: analysis of a large claims database

In patients with rotator cuff tears (RCTs), there is a lack of evidence regarding the impact of the timeliness of rotator cuff repair (RCR) surgery on treatment outcomes and overall healthcare burden. This study aimed to understand the impact of early vs. delayed RCR on real-world healthcare costs and resource use (HCRU) in Japan. This study utilized JMDC health insurance claims data from January 2012 to February 2021. Patients aged ≥18 years were included if they had ≥1 inpatient or ≥2 nondiagnostic outpatient claims (≥1 month apart) for RCT (diagnosis codes S460/S468), had RCR (procedure codes K080-X) within 12 months postindex, and had 12 months post-RCR continuous enrollment. Index month was defined upon the first RCT claim, and surgery month was defined upon the first RCR. Patients were categorized as having had early (≤1 month postindex) or delayed (2-12 months postindex) RCR. RCT-related HCRU were reported for the 12-month postindex or postsurgery periods. Of 1243 RCR patients, 68.9% were male and the mean (standard deviation [SD]) age was 55.3 (8.9) years. Of 46.3% patients with an initial diagnosis of tendinosis, their RCT was diagnosed for only a mean (SD) of 5.7 (4.0) months later. The mean (SD) time from index to first RCR was 2.4 (2.3) months; 518 (41.7%) patients had early RCR. The mean total RCT-related healthcare costs were higher for patients with delayed vs. early RCR (P < .05 for both postindex and surgery). The mean (SD) postsurgery inpatient costs were higher for delayed vs. early RCR (¥1,260,066 vs. ¥1,119,381; P < .05), possibly partly driven by longer hospital stays among delayed RCR patients. Patients with delayed RCR had a higher mean number of physical therapy visits compared with early RCR, especially postsurgery (42.6 vs. 38.4; P < .05); physical therapy costs were significantly higher for delayed RCR patients, compared with early RCR, for both postindex or postsurgery periods (P < .05). During the postindex period, higher proportions of delayed vs. early RCR patients received opioids (22.1% vs. 16.2%; P < .05), nonopioid pain medications (77.7% vs. 69.5%; P < .05), cortisone injections (47.2% vs. 33.8%; P < .05), and oral cortisone (4.8% vs. 1.4%; P < .05). The mean outpatient pharmacy prescription costs were significantly higher for delayed vs. early RCR for both the postindex and postsurgery periods (both P < .05). Long delays in the diagnosis or treatment of RCT in Japan may lead to higher burdens of healthcare. Patients with delayed RCR may require more prescription medications and/or PT before and after surgery. Improving the timeliness of RCT treatment could therefore reduce overall HCRU.

Real-world healthcare resource utilization, costs, and predictors of relapse among US patients with incident schizophrenia or schizoaffective disorder

Schizophrenia and schizoaffective disorder present burdens to patients and health systems through elevated healthcare resource utilization (HCRU) and costs. However, there is a paucity of evidence describing these burdens across payor types. To identify unmet needs, this study characterized patients with schizophrenia or schizoaffective disorder by payor type. We identified patients aged 12–94 years with newly diagnosed schizophrenia or schizoaffective disorder (index date) between 01/01/2014 and 08/31/2020 with continuous enrollment for 12 months before and after index date from the Healthcare Integrated Research Database. After stratifying by post-index relapse frequency (0, 1, or ≥2) and payor type (commercial, Medicare Advantage/Supplemental (Medigap)/Part D, or managed Medicaid), we examined patient characteristics, treatment patterns, HCRU, costs, and relapse patterns and predictors. During follow-up, 25% of commercial patients, 29% of Medicare patients, and 37% of Medicaid patients experienced relapse. Atypical antipsychotic discontinuation was most common among Medicaid patients, with 65% of these patients discontinuing during follow-up. Compared to commercial patients, Medicare and Medicaid patients had approximately half as many psychotherapy visits during follow-up (12 vs. 5 vs. 7 visits, respectively). Relative to baseline, average unadjusted all-cause costs during follow-up increased by 105% for commercial patients, 66% for Medicare patients, and 77% for Medicaid patients. Patients with schizophrenia or schizoaffective disorder had high HCRU and costs but consistently low psychotherapy utilization, and they often discontinued pharmacologic therapy and experienced relapse. These findings illustrate the high burden and unmet need for managing these conditions and opportunities to improve care for underserved patients.

Comparison of real-world healthcare resource utilization among advanced therapy-naïve and advanced therapy-experienced patients with ulcerative colitis initiated on ustekinumab or vedolizumab

Objectives To describe and compare healthcare resource utilization (HRU) among advanced therapy-naïve and advanced therapy-experienced patients with ulcerative colitis (UC) initiating ustekinumab or vedolizumab in the United States. Methods Claims data from IQVIA PharMetrics Plus de-identified database (01/01/2015–06/30/2022) were used to identify adult patients with UC initiating ustekinumab or vedolizumab (index date) after 10/21/2019. Baseline characteristics were balanced using inverse probability of treatment weighting. All-cause and UC-related HRU (number of inpatient admissions, inpatient days, emergency department visits, and outpatient visits) were described during the post-index period, and Poisson regression models were used to evaluate associations between index therapy and HRU outcomes. Analyses were performed separately among advanced therapy-naïve or advanced therapy-experienced patients. Results A total of 444 (ustekinumab) and 1,917 (vedolizumab) advanced therapy-naïve patients, and 647 (ustekinumab) and 1,152 (vedolizumab) advanced therapy-experienced patients were identified. In advanced therapy-naïve patients, higher rates of UC-related inpatient days (rate ratio [95% confidence interval] = 1.84 [1.15, 3.58]; p = 0.004), emergency department visits (1.39 [1.01, 2.17]; p = 0.044), and outpatient visits (1.81 [1.61, 2.04]; p < 0.001) were observed among patients initiating vedolizumab relative to ustekinumab. In advanced therapy-experienced patients, higher rates of UC-related inpatient admissions (1.47 [1.06, 2.12]; p = 0.012), inpatient days (2.18 (1.44, 3.71); p < 0.001), and outpatient visits (1.50 (1.19, 1.82); p < 0.001) were observed among patients initiating vedolizumab relative to ustekinumab. Results were similar when all-cause HRU was examined. Conclusions Among patients with UC with and without advanced therapy experience, higher rates of all-cause and UC-related HRU were observed among those treated with vedolizumab relative to ustekinumab.

Real-World Treatment Patterns, Health Outcomes, and Healthcare Resource Use in Advanced Common EGFR-Positive Non-Small Cell Lung Cancer Patients Treated with Osimertinib in Alberta.

There is limited information on the treatment trajectory and outcomes of patients with advanced cEGFRm NSCLC treated with osimertinib in routine clinical practice in Canada. By using and analyzing population-based administrative data and detailed chart abstraction in the province of Alberta, our objective was to capture Canadian-specific real-world treatment patterns, health outcomes, and healthcare resource utilization (HCRU) in advanced cEGFRm NSCLC patients who were (a) treated with osimertinib and (b) those receiving treatment after osimertinib. In our study cohort, we found that the overall survival rates for real-world patients receiving osimertinib were less favorable than those observed in clinical trials (24.0 versus 38.6 months). The attrition rate after osimertinib was substantial and high HCRU persisted across many years after diagnosis and treatment. This study provides important real-world evidence on contemporary survival, treatment patterns, and healthcare use among cEGFRm NSCLC patients treated with osimertinib and suggests that further research efforts are needed to improve therapeutic options in both the first and subsequent line settings.

Real-World Healthcare Resource Use Associated with Recurrent or Metastatic Head and Neck Cancer Patients Care in Portugal-TRACE Study.

Recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) is a challenging disease, requiring personalized management by a multidisciplinary team. The aim of this retrospective multicentric study was to characterize real-world healthcare resource use and patient care for R/M HNSCC in Portugal during the first year after diagnosis. A total of 377 patients ineligible for curative treatment were included, mostly male (92.8%), aged 50-69 years (74.5%), with heavy alcohol (72.7%) or smoking habits (89.3%). Oropharynx (33.2%) and oral cavity (28.7%) were primary tumor locations, with lung metastases being the most common (61.4%). Eligible patients for systemic treatment with palliative intent (80.6%) received up to four treatment lines, with varied regimens. Platinum-based combination chemotherapy dominated first-line treatment (>70%), while single-agent chemotherapy and anti-PD1 immunotherapy were prevalent in later lines. Treatment approaches were uniform across disease stages and primary tumor locations but varied geographically. Treated patients received more multidisciplinary support than those who were ineligible. This study provides the first Portuguese real-world description of R/M HNSCC patient characteristics, treatment patterns, and supportive care during the year after diagnosis, highlighting population heterogeneity and aiming to improve patient management.