Real-World Treatment Patterns, Healthcare Resource Utilization, and Healthcare Costs in the First-Line Treatment of Metastatic Non-Small Cell Lung Cancer in the US

Abstract

This study characterizes real-world treatment patterns and economic and healthcare resource utilization (HCRU) burden associated with first-line (1L) treatment of metastatic non-small cell lung cancer (NSCLC) without actionable alterations in the United States. This retrospective observational study used Optum Clinformatics® data. A total of 15,659 patients with metastatic NSCLC who started 1L treatment between January 2020 and March 2023 were included (52% male; mean age at the start of 1L treatment 71.7 years; 86% Medicare Advantage). The most frequent 1L regimens were immune checkpoint inhibitor (ICI) + platinum-based chemotherapy (PBCT) (47%), PBCT only (26%), and ICI only (20%). The median 1L treatment duration was 4.2 months (range 2.7–6.5) and was shorter with chemotherapy-only regimens. Outpatient visits accounted for the majority of HCRU (mean 6.6 visits per patient per month [PPPM]). Outpatient, inpatient, and emergency department visits were highest for chemotherapy-only regimens. Mean total (all-cause) healthcare costs were $32,215 PPPM and were highest for ICI + chemotherapy ($34,741–38,454 PPPM). Inpatient costs PPPM were highest for PBCT ($4725) and ICI + non-PBCT ($4648). First-line treatment of metastatic NSCLC without actionable alterations imposes a notable HCRU and cost burden, underscoring the need for better treatment options to improve outcomes and reduce economic impact.