VALUE IN HEALTH - MAY 2020
AWV (OR =0.77, 95%CI =0.75, 0.80). Even after adjusting for all the covariates, women
with a cancer history were significantly less likely to receive AWV (AOR = 0.71, 95% CI
= 0.68, 0.74) compared to those without cancer history. In addition, those aged 66 to
79 years and with comorbidities were more likely to use AWV compared to their
counterparts. Conclusions: In this first population-based study, one in 10 older
women with a cancer history used AWV. Our study findings highlight the very low-
uptake of AWV among older women with and without cancer during the initial years
of ACA. Future studies need to explore barriers to AWV and develop targeted in-
terventions to improve AWV rates among women diagnosed with cancer
. Sundaram M,1 Ghosh N,2 Kadish K,3 Upasani S,4 Han J,1
PCN364
HOSPITAL UTILIZATION AND COSTS OF MALE BREAST
CANCER PATIENTS IN THE UNITED STATES: AN ANALYSIS
OF NATIONWIDE INPATIENT SAMPLE
Park SK,1 Ng BP,2 Chun HK,3 Park C3
1 patients receiving treatment for chronic lymphocytic leukemia (CLL)/small lym-
Northeastern University, Malden, MA, USA, 2University of Central Florida,
Orlando, FL, USA, 3Northeastern University, Boston, MA, USA
Objectives: Numerous studies about hospital utilization and costs in female breast
cancer (BC) patients have been published. However, the evidence focusing on male
BC is scarce, and it is necessary due to the different clinical characteristics between
female and male BC. The objective of this study is to assess hospital utilization and
costs associated with male BC in the U.S. Methods: We analyzed the 2012-2016
Health Care Utilization Project-National Inpatient Sample of 448 male BC patients,
who were diagnosed with BC based on primary International Classification of Disease
(ICD)-9/10-CM codes. The BC-related variables included the history of breast con-
servatory and mastectomy surgery, and metastatic status. The outcome variables
were a length of stay (LoS) and hospitalization costs. A negative binomial regression
and a generalized linear model with log-link and gamma distribution adjusted for
socio-demographics and comorbidities were conducted to estimate LoS and hospi-
talization costs by BC-related characteristics. Results: On average, male BC patients
stayed for 2.4 days [95% confidence interval (CI): 2.12-2.70] and expended $9,097
[95% CI: $8,437-9,757] per hospital visit. Patients who underwent surgery procedures
had significantly shorter stays (1.90 days [95% CI: 1.58-2.24]) compared to the no-
surgery group (3.35 days [95% CI: 2.46-4.24]). However, hospitalization costs were
not significantly different between the surgery ($8,898 [95% CI: 7,929-9,868]) and the
no-surgery group ($8,872 [95% CI: 6,983-10,605]). Those with metastatic status had
greater LoS (5.28 days [95% CI: 4.04-6.52] vs. 3.30 days [95% CI: 2.38-4.20]) and
hospitalization costs ($11,366 [95% CI: 8,910-13,822] vs. $8,805 [95% CI: 6,963-
10,647]) than those without. Conclusions: This study revealed that the LoS and
hospitalization costs of male BC were associated with the surgery and metastatic
status. The information can be used to assess the healthcare resources needed to
treat male BC.
PCN365
CLINICAL CHARACTERISTICS AND MANAGEMENT COSTS
OF FEBRILE NEUTROPENIA IN ONCOLOGY PATIENTS IN A
HEALTH CARE INSTITUTION IN COLOMBIA
Lema M,1 Preciado BE,1 Castaño Gamboa N,2 Reyes Sanchez JM,3
Quiceno DM,1 Mora SP1
1
SOMA Clinic, Medellin, Colombia, 2Pfizer SAS, Bogotá, Colombia, 3Pfizer SAS,
Bogota, CUN, Colombia
Objectives: To describe the clinical characteristics, resource utilization and cost of
management (COM) of febrile neutropenia (FN) in oncology inpatients. Methods: This
is a descriptive and retrospective study of a cohort of patients hospitalized due to
FN in Clínica SOMA - a health care institution in Medellín (Colombia) - from 2017
to 2019. The costs were extracted from the review of medical records from
diagnosis of FN until discharge or death. Costs were classified as laboratories,
medications, hospital length-of-stay (LOS), and specialist physician fees. FN epi-
sodes were classified as high-risk or low-risk according to the MASCC-scale.
Official government manual and drug price information system were used to es-
timate the cost, which were expressed in 2019 US dollars (US$). The exchange rate
applied was 3,278 colombian pesos per US$. Results: Forty-four FN episodes were
included. Median age was 61 years (IQR: 53-72), female (52.3%). Solid tumors
accounted for 68.8%. The most frequent cancer diagnoses were colorectal (13.6%),
breast (11.4%) and lung (9.1%). In terms of oncology treatments, 14 (31.8%) patients
were in first-line; 14 (31.8%) in the adjuvant/neoadjuvant setting; and 5 (11.4%), in
second-line (2L); 15 (34.0%) episodes occurred in the high-risk setting. Mean LOS
per episode was 5.7 62.9 days. All patients were discharged alive. Highest COM
was found in the 2L group (mean +/- sd: US$1,3826610). COM was higher in high-
risk patients ($1,192 6 1,025) as compared to low-risk (US$770 6 581). The me-
dian overall COM was $633 (range:US US$262- US$3,376) per episode, being
hospital LOS the main driver cost. Conclusions: Febrile neutropenia occurred
mainly in advanced-stage solid tumors and in MASCC low-risk patients. Higher
S89
costs in this cohort were found in long hospital length of stay, and 2L or high-risk
patients.
PCN366
TREATMENT AND PROGNOSTIC TESTING PATTERNS IN
PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA: THE
INFORMCLLTM REAL-WORLD REGISTRY INTERIM
ANALYSIS
Amaya-Chanaga C,4 Iyengar R4
1
Janssen Scientific Affairs, LLC, Horsham, PA, USA, 2Levine Cancer Institute,
Charlotte, NC, USA, 3Tufts Medical Center, Boston, MA, USA, 4Pharmacyclics
LLC, an AbbVie Company, Sunnyvale, CA, USA
Objectives: To report treatment and prognostic testing patterns for patients enrolled
in informCLL (NCT02582879), a US-based, prospective, observational registry of
phocytic lymphoma. Methods: In October 2015, registry enrollment began for
eligible patients $18 years who started approved anti-CLL therapy within 45 days.
Initial treatments were grouped as: ibrutinib, chemoimmunotherapy (CIT), chemo-
therapy, immunotherapy, and other novel agents. Available prognostic biomarker
testing was recorded at registry enrollment. Descriptive analyses for testing and
dosing rates are presented. Results: At time of analysis (11/30/2018), 1181 patients
(previously untreated [1L]: n=686; relapsed/refractory [R/R]: n=495) were enrolled.
Median (range) follow-up time was 11.8 months (0.03–35.88). Most patients (95%)
were treated in community settings; median age was 70 years (34–95). At enroll-
ment, the most common treatment groups were ibrutinib (44%, 518/1181) and CIT
(34%, 405/1181). CIT was most common in 1L patients (43%, 296/686); ibrutinib was
most common in R/R patients (48%, 238/495). Prognostic biomarker testing was
performed in 29% (FISH) and 11% (IGHV) of all patients. Among those tested, 30% (26/
86) with del(17p) and 38% (35/93) with unmutated IGHV received CIT. Of patients
receiving ibrutinib, 88% started at 420 mg/day; 81% did not require dose modifica-
tions. In patients completing treatment, median cycles received were 5 bend-
amustine+rituximab, 5 fludarabine+cyclophosphamide+rituximab, and 6
obinutuzumab+chlorambucil, with 85/109 (78%), 28/33 (85%), and 18/44 (41%),
respectively, receiving ,6 cycles. Conclusions: Low prognostic testing rates (#29%)
were reported in informCLL; approximately one-third of high-risk patients still
received CIT despite current treatment guidelines. These results highlight that
increased awareness and education are needed to support routine prognostic testing
to better guide treatment decisions that optimize clinical outcomes for patients with
CLL and real-world outcomes for payors.
PCN367
BREAST CANCER PAIN CONDITIONS AND MEDICATION
USE AMONG COMMERCIALLY INSURED BREAST CANCER
PATIENTS
Lakkad M1, Painter JT2
1
University of Arkansas for Medical Sciences College of Pharmacy, Little Rock,
AR, USA, 2University of Arkansas for Medical Sciences, Little Rock, AR, USA
Objectives: Pain among breast cancer patients severely affects patient’s quality of life
and puts enormous burden on the healthcare system. This study describes incident
pain diagnoses and pain medication use among newly diagnosed breast cancer pa-
tients. Methods: Retrospective descriptive analysis study using commercially
insured population claims data (2008 – 2018) was conducted. Female breast
cancer patients older than 18 years of age with 6 months of continuous enrollment
before cancer diagnosis and 15 months after were included. Pain conditions were
divided into acute, subacute and chronic conditions and medications were divided
into non-opioid, opioids, opioid combinations and adjuvant analgesics. Identifi-
cation of incident pain conditions and medications use was carried out using
international classification of disease 9/10 clinical modification (ICD9/10 CM) and
generic product identifier (GPI) codes. Student t-test and chi square test were used
for comparisons as appropriate. All analysis was conducted in SAS version 9.4,
Cary, N.C. Results: 8420 patients were included, 17.9% were diagnosed with acute
pain, 10.1% with subacute and 16% with chronic pain, and 56.3% with no pain.
Mean age was 59 years among all three pain conditions (p=0.84). Lumbosacral
radiculopathy, lymphedema and post mastectomy pain syndrome were the
highest observed pain conditions among breast cancer patients (19%, 11.8% and
9.7%) respectively. The most commonly prescribed medications for pain relief
were opioids and its combinations and non-opioid analgesics (47% and 18%)
respectively. Conclusions: Among the newly diagnosed breast cancer patients,
44% were diagnosed with incident pain conditions. Radiculopathy and lymphe-
dema were the top two pain conditions observed. Opioids and its combinations
and non-opoid analgesics were the highest prescribed pain medications to breast
cancer patients for pain relief.