Main Session
Sep
29
QP 03 - HSR 1: Quick Pitch: From Data to Delivery: Health Services Insights in Radiation Oncology
1015 - Healthcare Costs Associated with Esophageal Cancer Treatment and Survivorship
Presenter(s)
Kyra Tito, MS - Morehouse School of Medicine, Atlanta, GA
K. Tito1, K. Shah2, L. Petersen3, M. R. Abdelaal3, S. W. Dutta4, N. Ali5, P. R. Patel6, J. Y. Lin7, J. Switchenko3, A. Marra8, and S. Rudra6; 1Morehouse School of Medicine, Atlanta, GA, 2Emory University, Atlanta, GA, 3Emory University School of Medicine, Atlanta, GA, 4Department of Radiation Oncology, Emory University, Atlanta, GA, 5University of Rochester School of Medicine and Dentistry, Rochester, NY, 6Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, 7Glenn Family Breast Center, Winship Cancer Institute, Emory University, Atlanta, GA, 8Winship Cancer Institute at Emory University, Atlanta, GA
Purpose/Objective(s):
Radiation therapy is commonly utilized in the management of esophageal cancer. Proton therapy is increasingly being offered to patients with a diagnosis of esophageal cancer as this modality reduces dose to organs at risk and incidence of side effects. There is limited data documenting healthcare associated costs of proton therapy utilization in this patient population. We compared the costs of proton therapy and photon therapy for esophageal cancer patients, evaluating both initial treatment and survivorship costs. We hypothesized that proton therapy would result in higher costs during the treatment period but lower costs in survivorship due to fewer late side effects.Materials/Methods:
We analyzed reimbursed healthcare claims data of US adults diagnosed with esophageal cancer treated with chemotherapy and radiation therapy from 2015 to 2022 using the IBM MarketScan Commercial Claims Database. Healthcare costs were calculated from 3 time periods: baseline (1-12 months before diagnosis), treatment (0 – 12 months after diagnosis), and survivorship (13 – 60 months after diagnosis). Median monthly excess costs comparing proton vs. photon therapy were calculated for treatment and survivorship periods as compared to the baseline period. This allowed for control of potential patient comorbidities and healthcare consumption prior to diagnosis and treatment of esophageal cancer.Results:
Of 42,155 esophageal cancer patients, 40,944 (97.1%) and 1,211 (2.9%) received photon and proton therapy, respectively. The median age was 53 years (range: 18-67) and 55.3% were female. Median monthly excess costs were higher for proton therapy than photon therapy during both the treatment period [$509 (95% CI 504-514) vs. $410 (404-417)] and survivorship period [$58 (53-63) vs. $24(18-31)]. Proton therapy had higher excess survivorship period costs at 24 months [$42 (38-46) vs $18 (13-22)], 36 months [$33 (30-35) vs $14 (10-17)] and 48 months [$25 (23-27) vs $11 (8-13)] after diagnosis. Gender-based cost differences were also observed, with female patients incurring higher total costs during the treatment period ($390/month, 95% CI $160-$620).Conclusion:
Proton therapy patients experienced increased healthcare costs during both treatment and survivorship. These findings suggest that potential benefits of proton therapy in this patient population do not translate to decreased costs in the short-term. Future research should assess more extended survivorship periods to identify any potential cost benefits to proton therapy.