Patients receiving treatment for ovarian cancer experienced a significant out-of-pocket financial burden, due largely to cost disparities across treatment types and a lack of definitive treatment options, according to research presented at the 2017 ASCO Annual Meeting (June 2-6, 2017; Chicago, IL).
Patients with high deductible health plans faced the largest out-of-pocket burden, results showed.
Presently, no clinical consensus has been reached as to the best course of treatment for epithelial ovarian cancer.
Larissa Meyer, MD, MPH, FACOG, FACS, assistant professor of gynecologic oncology at The University of Texas MD Anderson Cancer Center (Houston, TX), and colleagues sought to determine estimated costs across treatment strategies in this patient population. Using MarketScan, they identified 12,761 patients who underwent treatment between 2006 and 2015.
The researchers categorized patients based on whether they were treated with primary debulking surgery and chemotherapy (n = 11,091) or neoadjuvant chemotherapy with interval debulking (n = 1670). They further separated patients based on chemotherapy type: standard intravenous (IV) chemotherapy (n = 9739); dose-dense IV chemotherapy (n = 1679); or intraperitoneal chemotherapy (n = 1343). Patients were further characterized based on whether they received bevacizumab (n = 849) or not (n = 11,912).
The adjusted mean out-of-pocket costs for primary debulking was US $2791; the average costs were slightly lower for patients who elected to receive neoadjuvant chemotherapy ($2362). Adjusted mean out-of-pocket costs varied by type of chemotherapy, with dose-dense IV chemotherapy the most expensive ($3193).
Regimens including bevacizumab had a significantly higher adjusted mean total cost ($160,781 vs $97,931; P < .001). Twenty-five percent of patients treated with bevacizumab had out-of-pocket costs exceeding $4200, and 10% had costs exceeding $6222.
The highest out-of-pocket costs were seen among women with high-deductible health insurance plans, who had mean out-of-pocket costs of $4680. Ten percent of women with high-deductible plans paid a total of $9144 or more out-of-pocket.
“To narrow the gap of cost disparities across treatment types of ovarian cancer, promoting patient assistance programs that specifically target low-income populations that don’t have as much access to resources would be beneficial,” a researcher involved in the study told Journal of Clinical Pathways.—Zachary Bessette