SEER-Medicare Database Analysis Notes Higher Resource Utilization Among Patients With Neuroendocrine Tumors

NEUROENDOCRINE TUMORS (NETs)

are diagnosed in over 12,000 people in the United States each year,¹ and survival varies by tumor type and location, among other factors.

A previous study found a significant increase in resource utilization among patients with advanced NETs, independent of the NET tumor site.² However, in that study, patients with pancreatic NETs had a higher rate of surgical procedures compared with those who had gastrointestinal tract or lung NETs; chemotherapy use was higher in the GI tract/lung NET population.

In the current study,³ presented at the 2017 American Society of Clinical Oncology Annual Meeting, researchers at MD Anderson Cancer Center used data on 12,052 elderly patients diagnosed with NETs between January 2003 and December 2011 using ICD-O-3 codes from the Surveillance, Epidemiology and End Results Medicare database, with continuous Medicare Parts A and B enrollment during a 1-year period prior to NET diagnosis. Propensity score matching was used to identify a group of comparable elderly patients from a noncancer Medicare cohort as the control sample.

Potentially relevant conditions (defined as a greater than 1 indicative claim), resource utilization, and costs from patients’ medical claims were documented for the 1-year period before diagnosis. To calculate resource utilization, the authors examined the number of outpatient visits, emergency department (ED) visits, and hospitalizations. Healthcare costs included inpatient, outpatient, and total costs.

The study found a higher likelihood of diarrhea (8% vs 2%), abdominal pain (37% vs 8%), irritable bowel syndrome (1.5% vs 0.6%), hypertension (72% vs 55%), heart failure (16% vs 8%), and peripheral edema (7% vs 4%) in the NET cohort compared with the non-cancer control group, respectively. Patients with NETs also had more outpatient visits (mean, 27.25 vs 18.45) and a higher percentage of ED visits (64% vs 36%) and hospitalizations (66% vs 34%).

Concurrently, patients with NETs had a significant increase in total (mean, $32,924 vs $10,048), outpatient (mean, $8869 vs 4580), and inpatient costs (mean, $24,055 vs $10,048) compared with the control cohort (all P <.001).

Based on their results, the authors conclude that patients with NETs incurred higher resource utilizations and costs in the year preceding the diagnosis of an NET.REFERENCES

1. Neuroendocrine tumor: statistics. Cancer.Net website. cancer.net/cancer-types/neuroendocrine-tumor/statistics. Accessed June 20, 2017.

2. Strosberg J, Casciano R, Stern L, et al. United States-based practice patterns and resource utilization in advanced neuroendocrine tumor treatment. World J Gastroenterol. 2013;19(15):2348-2354. doi: 10.3748/wjg.v19. i15.2348.

3. Shen C, Chu Y, Dasari A, et al. Pre-existing symptoms, resource utilization, and healthcare costs prior to diagnosis of neuroendocrine tumors: a SEER-Medicare database study. J Clin Oncol. 2017;35(suppl; abst 4092).

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