Kidney Cancer Coverage from Every Angle

Quality Care 2019: Cost of Treatment Per Episode of Care in Metastatic Kidney Cancer

By: Sarah Campen, PharmD
Posted: Monday, September 9, 2019

In recent years, a shift in reimbursement models for oncology care in the United States from traditional fee-for-service toward episode-based care has set the framework for assessing the value of therapies. An analysis presented at the 2019 American Society of Clinical Oncology (ASCO) Quality Care Symposium (Abstract 55) in San Diego found that in the treatment of metastatic renal cell carcinoma, significant differences in total episode costs exist in each monotherapy class.

“As health-care financing shifts to alternative payment models, it is important to investigate overall episode cost of care for various therapies, as the cost for the individual drug may not accurately reflect the total episode value,” stated Anne Kangethe, PharmD, MPH, PhD, of Magellan Rx Management, Scottsdale, Arizona, and colleagues.

The researchers performed a retrospective analysis of commercial claims data incurred between January 1, 2013, and June 30, 2018. Eligible patients (n = 606) had at least one claim with a diagnosis code of renal cell carcinoma and a minimum of two claims for metastasis on or after the initial renal cell carcinoma diagnosis date. Patients were then classified into one of six therapy classes: tyrosine kinase inhibitor (TKI) monotherapy, mTOR monotherapy, immuno-oncology monotherapy, other monotherapy (such as interferon), changed therapy class, or traditional chemotherapy.

Most patients received monotherapy, and about half (53%) had at least two episodes. With an average of 7 days per episode, patients receiving immuno-oncology had the longest inpatient length of stay (P = .0002). The average total episode costs among each selected therapeutic class follow: TKI (n = 161; $61,417), mTOR (n = 30; $67,637), immuno-oncology (n = 75; $92,082), other (n = 34; $98,877), changed therapy (n = 130; $84,480), and chemotherapy (n = 34; $55,743).

Disclosure: The study authors’ disclosure information may be found at

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