Impact of new drugs and biologics on colorectal cancer treatment and costs

Pinar Karaca-Mandic, Jeffrey S. McCullough, Mustaqeem A. Siddiqui, Holly Van Houten, Nilay D Shah

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: To compare medical expenditures of patients receiving old and new colorectal cancer (CRC) regimens. Study Design: Using claims data, we identified 2 cohorts of privately insured patients diagnosed with CRC: first, those diagnosed before new treatment introduction (January 1, 2002, to December 31, 2002), and second, those diagnosed after new treatment introduction (June 1, 2004, to May 31, 2005). CRC diagnosis was identified using International Classification of Diseases-9 codes 153.xx, 154.xx, and 159.0. First- and second-line chemotherapy regimens were identified. Treatments and expenditures were then observed for up to 2 years after initial diagnosis. Methods: We estimated multivariate models to measure changes in cost with changes in treatment regimen. Approval dates of new regimens were used as natural experiments. Results: New regimens, such as fluorouracil, leucovorin, and oxaliplatin (FOLFOX), have rapidly replaced the most prevalent preperiod product (ie, fluorouracil/leucovorin). Changes in treatment have caused large increases in total expenditure, primarily through increases in chemotherapy prices. FOLFOX alone has increased total average cost by 14%. New treatments have not substituted for other medical services; rather, they have indirectly raised costs through nonstandard regimen use and increases in second-line treatment use. We found no evidence that expenditure effects were driven by changes in follow-up duration. Conclusion: New CRC treatments have increased both regimen choice and expenditures. New regimens have primarily increased expenditures through direct treatment costs; we observed no offsetting expenditure reductions.

Original languageEnglish (US)
JournalAmerican Journal of Managed Care
Volume17
Issue number5
StatePublished - May 2011

Fingerprint

Biological Products
Health Care Costs
Health Expenditures
Colorectal Neoplasms
Pharmaceutical Preparations
oxaliplatin
Leucovorin
Therapeutics
Costs and Cost Analysis
Fluorouracil
Drug Therapy
International Classification of Diseases

ASJC Scopus subject areas

  • Health Policy

Cite this

Karaca-Mandic, P., McCullough, J. S., Siddiqui, M. A., Van Houten, H., & Shah, N. D. (2011). Impact of new drugs and biologics on colorectal cancer treatment and costs. American Journal of Managed Care, 17(5).

Impact of new drugs and biologics on colorectal cancer treatment and costs. / Karaca-Mandic, Pinar; McCullough, Jeffrey S.; Siddiqui, Mustaqeem A.; Van Houten, Holly; Shah, Nilay D.

In: American Journal of Managed Care, Vol. 17, No. 5, 05.2011.

Research output: Contribution to journalArticle

Karaca-Mandic, P, McCullough, JS, Siddiqui, MA, Van Houten, H & Shah, ND 2011, 'Impact of new drugs and biologics on colorectal cancer treatment and costs', American Journal of Managed Care, vol. 17, no. 5.
Karaca-Mandic P, McCullough JS, Siddiqui MA, Van Houten H, Shah ND. Impact of new drugs and biologics on colorectal cancer treatment and costs. American Journal of Managed Care. 2011 May;17(5).
Karaca-Mandic, Pinar ; McCullough, Jeffrey S. ; Siddiqui, Mustaqeem A. ; Van Houten, Holly ; Shah, Nilay D. / Impact of new drugs and biologics on colorectal cancer treatment and costs. In: American Journal of Managed Care. 2011 ; Vol. 17, No. 5.
@article{3c5f748dddc145a18cfc86d4644b1f63,
title = "Impact of new drugs and biologics on colorectal cancer treatment and costs",
abstract = "Objective: To compare medical expenditures of patients receiving old and new colorectal cancer (CRC) regimens. Study Design: Using claims data, we identified 2 cohorts of privately insured patients diagnosed with CRC: first, those diagnosed before new treatment introduction (January 1, 2002, to December 31, 2002), and second, those diagnosed after new treatment introduction (June 1, 2004, to May 31, 2005). CRC diagnosis was identified using International Classification of Diseases-9 codes 153.xx, 154.xx, and 159.0. First- and second-line chemotherapy regimens were identified. Treatments and expenditures were then observed for up to 2 years after initial diagnosis. Methods: We estimated multivariate models to measure changes in cost with changes in treatment regimen. Approval dates of new regimens were used as natural experiments. Results: New regimens, such as fluorouracil, leucovorin, and oxaliplatin (FOLFOX), have rapidly replaced the most prevalent preperiod product (ie, fluorouracil/leucovorin). Changes in treatment have caused large increases in total expenditure, primarily through increases in chemotherapy prices. FOLFOX alone has increased total average cost by 14{\%}. New treatments have not substituted for other medical services; rather, they have indirectly raised costs through nonstandard regimen use and increases in second-line treatment use. We found no evidence that expenditure effects were driven by changes in follow-up duration. Conclusion: New CRC treatments have increased both regimen choice and expenditures. New regimens have primarily increased expenditures through direct treatment costs; we observed no offsetting expenditure reductions.",
author = "Pinar Karaca-Mandic and McCullough, {Jeffrey S.} and Siddiqui, {Mustaqeem A.} and {Van Houten}, Holly and Shah, {Nilay D}",
year = "2011",
month = "5",
language = "English (US)",
volume = "17",
journal = "American Journal of Managed Care",
issn = "1088-0224",
publisher = "Ascend Media",
number = "5",

}

TY - JOUR

T1 - Impact of new drugs and biologics on colorectal cancer treatment and costs

AU - Karaca-Mandic, Pinar

AU - McCullough, Jeffrey S.

AU - Siddiqui, Mustaqeem A.

AU - Van Houten, Holly

AU - Shah, Nilay D

PY - 2011/5

Y1 - 2011/5

N2 - Objective: To compare medical expenditures of patients receiving old and new colorectal cancer (CRC) regimens. Study Design: Using claims data, we identified 2 cohorts of privately insured patients diagnosed with CRC: first, those diagnosed before new treatment introduction (January 1, 2002, to December 31, 2002), and second, those diagnosed after new treatment introduction (June 1, 2004, to May 31, 2005). CRC diagnosis was identified using International Classification of Diseases-9 codes 153.xx, 154.xx, and 159.0. First- and second-line chemotherapy regimens were identified. Treatments and expenditures were then observed for up to 2 years after initial diagnosis. Methods: We estimated multivariate models to measure changes in cost with changes in treatment regimen. Approval dates of new regimens were used as natural experiments. Results: New regimens, such as fluorouracil, leucovorin, and oxaliplatin (FOLFOX), have rapidly replaced the most prevalent preperiod product (ie, fluorouracil/leucovorin). Changes in treatment have caused large increases in total expenditure, primarily through increases in chemotherapy prices. FOLFOX alone has increased total average cost by 14%. New treatments have not substituted for other medical services; rather, they have indirectly raised costs through nonstandard regimen use and increases in second-line treatment use. We found no evidence that expenditure effects were driven by changes in follow-up duration. Conclusion: New CRC treatments have increased both regimen choice and expenditures. New regimens have primarily increased expenditures through direct treatment costs; we observed no offsetting expenditure reductions.

AB - Objective: To compare medical expenditures of patients receiving old and new colorectal cancer (CRC) regimens. Study Design: Using claims data, we identified 2 cohorts of privately insured patients diagnosed with CRC: first, those diagnosed before new treatment introduction (January 1, 2002, to December 31, 2002), and second, those diagnosed after new treatment introduction (June 1, 2004, to May 31, 2005). CRC diagnosis was identified using International Classification of Diseases-9 codes 153.xx, 154.xx, and 159.0. First- and second-line chemotherapy regimens were identified. Treatments and expenditures were then observed for up to 2 years after initial diagnosis. Methods: We estimated multivariate models to measure changes in cost with changes in treatment regimen. Approval dates of new regimens were used as natural experiments. Results: New regimens, such as fluorouracil, leucovorin, and oxaliplatin (FOLFOX), have rapidly replaced the most prevalent preperiod product (ie, fluorouracil/leucovorin). Changes in treatment have caused large increases in total expenditure, primarily through increases in chemotherapy prices. FOLFOX alone has increased total average cost by 14%. New treatments have not substituted for other medical services; rather, they have indirectly raised costs through nonstandard regimen use and increases in second-line treatment use. We found no evidence that expenditure effects were driven by changes in follow-up duration. Conclusion: New CRC treatments have increased both regimen choice and expenditures. New regimens have primarily increased expenditures through direct treatment costs; we observed no offsetting expenditure reductions.

UR - http://www.scopus.com/inward/record.url?scp=79960224593&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79960224593&partnerID=8YFLogxK

M3 - Article

C2 - 21711066

AN - SCOPUS:79960224593

VL - 17

JO - American Journal of Managed Care

JF - American Journal of Managed Care

SN - 1088-0224

IS - 5

ER -