TY - JOUR
T1 - Trends and drivers of pharmaceutical expenditures from systemic anti-cancer therapy
AU - Børty, Lars
AU - Brøndum, Rasmus F.
AU - Christensen, Heidi S.
AU - Vesteghem, Charles
AU - Severinsen, Marianne
AU - Johnsen, Søren P.
AU - Ehlers, Lars H.
AU - Falkmer, Ursula
AU - Poulsen, Laurids Ø.
AU - Bøgsted, Martin
PY - 2023/8
Y1 - 2023/8
N2 - Expenditures on medicine for systemic anti-cancer therapy (SACT) have seen large increases in recent years. The characterization of patients with high SACT costs is crucial to identify cost-driving factors, but little is known about the distribution of expenditures at the patient-level. We priced 260,834 registrations of SACT for 12,589 patients from 2008 to 2019 by combining them with product-level billings of EUR 142.1 million. Based on this, we defined high-cost patients as the 2.5% most expensive by accumulated SACT expenditures. We found that high-cost patients accounted for 28.8% of the total SACT expenditures and were observed across all major cancer groups except for pancreatic cancer. The risk of becoming a high-cost patient was increased for younger age groups, i.e., 18-44 and 45-64 years, for patients with BMI ≥ 25, and for patients with multiple cancer diagnoses, while no alteration of risk was observed due to comorbidities or sex. Changes in the characteristics of high-cost patients during the study period were found with an increased risk of becoming high-cost in later years for elderly patients and patients with lung cancer and a decreased risk for breast cancer patients.
AB - Expenditures on medicine for systemic anti-cancer therapy (SACT) have seen large increases in recent years. The characterization of patients with high SACT costs is crucial to identify cost-driving factors, but little is known about the distribution of expenditures at the patient-level. We priced 260,834 registrations of SACT for 12,589 patients from 2008 to 2019 by combining them with product-level billings of EUR 142.1 million. Based on this, we defined high-cost patients as the 2.5% most expensive by accumulated SACT expenditures. We found that high-cost patients accounted for 28.8% of the total SACT expenditures and were observed across all major cancer groups except for pancreatic cancer. The risk of becoming a high-cost patient was increased for younger age groups, i.e., 18-44 and 45-64 years, for patients with BMI ≥ 25, and for patients with multiple cancer diagnoses, while no alteration of risk was observed due to comorbidities or sex. Changes in the characteristics of high-cost patients during the study period were found with an increased risk of becoming high-cost in later years for elderly patients and patients with lung cancer and a decreased risk for breast cancer patients.
KW - Expensive patients
KW - High utilizers
KW - High-cost patients
KW - Medicine expenditures
KW - Oncology
KW - Systemic anti-cancer therapy
UR - http://www.scopus.com/inward/record.url?scp=85137022074&partnerID=8YFLogxK
U2 - 10.1007/s10198-022-01515-0
DO - 10.1007/s10198-022-01515-0
M3 - Journal article
C2 - 36028607
SN - 1618-7598
VL - 24
SP - 853
EP - 865
JO - The European Journal of Health Economics
JF - The European Journal of Health Economics
IS - 6
ER -