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P.A. Gonzales
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P3.07 - Poster Session with Presenters Present (ID 493)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Regional Aspects/Health Policy/Public Health
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.07-005 - US Healthcare without Payer Restrictions or Out-Of-Pocket Costs: Treatment of Advanced NSCLC in the Military Health System (ID 6029)
14:30 - 14:30 | Author(s): P.A. Gonzales
- Abstract
Background:
Cancer treatment practices in the United States are affected by multiple factors to include out-of-pocket patient costs, payer restrictions, and access to care. Facilities in the United States Military Health System offer a unique opportunity to explore treatment practices in a closed system not limited by previously stated factors. We conducted a study to explore the patterns of care and identify unique aspects in the treatment of advanced stage non-small cell lung cancer at a large United States military medical center where patients have no out-of-pocket costs and no payer restrictions.
Methods:
We conducted a retrospective chart review of patients who initiated palliative chemotherapy for NSCLC from 01 July 2011 to 01 July 2014 at San Antonio Military Medical Center. Patient demographics, tumor characteristics, chemotherapy history, and radiology studies were collected.
Results:
A total of 68 patients were included in the review with 54 having stage IIIB or IV disease and the remaining 14 having a metastatic recurrence of earlier stage disease. The median age was 64 with a range from 42 to 91. 41 (60%) were adenocarcinoma, 21 (31%) were squamous, and 6 (9%) were poorly differentiated histology. 57 (84%) patients had an ECOG of 0 or 1 and 50 (74%) had a smoking history. The mean number of lines of chemotherapy was 2.1 with a range of 1 to 6. The average frequency of CT based imaging was every 3 months with contrasted CT scans alone being 2.5 times more frequent than PET CT scans of diagnostic quality. Of the 62 patients without a sensitizing molecular alteration, 55 (89%) were treated with an upfront triplet or doublet platinum based regimen. 59% of patients received at least 2 lines of therapy, 30% received 3 lines, 13% received 4 lines, and 6% received greater than 4 lines of therapy. 14% of patients with negative or unknown EGFR mutation status received erlotinib during later lines of treatment.
Conclusion:
Despite not facing payer restrictions or out-of-pocket costs, patients treated in the United States Military Health System received a similar number of lines of palliative chemotherapy as reported in other retrospective reviews. This study suggests that payer restrictions and out-of-pocket costs may not have a significant impact on the patterns of care in the treatment of advanced non-small cell lung cancer in the United States.
