Healthcare Resource Utilization and Costs After Disease Progression With First-Line Systemic Therapy in Patients With Advanced Endometrial Cancer in the United States

OBJECTIVES: This retrospective claims-based analysis explored the association of treatment-free interval (TFI) with healthcare resource utilization (HCRU) and direct medical costs among patients with advanced endometrial cancer (EC) who reached at least a second line of therapy. METHODS: Registry of closed claims. Eligible patients had an EC diagnosis between January 1, 2016, and June 30, 2021, with continuous enrollment benefits for ≥12 months preceding and ≥30 days following second-line therapy initiation. All-cause and EC-specific HCRU per patient per month were summarized descriptively for TFI cohorts of <6 or ≥6 months. Generalized linear models assessed the association between TFI and costs, adjusting for patient characteristics. RESULTS: Of 2484 patients included, 2102 (85%) had a TFI of <6 months. Overall, all-cause and EC-specific HCRU rates were 92.1% and 78.7% (physician office visits), 48.9% and 19.8% (emergency department visits), and 42.0% and 17.4% (hospitalizations), respectively. Mean total all-cause costs per patient per month were numerically higher among patients with a shorter TFI (<6-month TFI, $9881; ≥6-month TFI, $9638; cost ratio, 0.961; P =.4854). EC-specific costs were significantly higher among the shorter TFI cohort (<6-month TFI, $5993; ≥6-month TFI, $5263; cost ratio, 0.747; P <.0001). CONCLUSIONS: Patients with advanced EC initiating subsequent treatment face considerable HCRU and costs. Because most patients had a <6-month TFI, which is indicative of faster disease progression and associated with numerically higher HCRU and significantly higher EC-specific costs, this study suggests that effective up-front treatments may help alleviate this burden.