Real-world analysis of cost, treatment patterns, and outcomes of patients with metastatic cutaneous squamous cell carcinoma in the US

Expert Rev Pharmacoecon Outcomes Res. 2023 Jul-Dec;23(8):911-920. doi: 10.1080/14737167.2023.2223982. Epub 2023 Jun 21.

Abstract

Objectives: To describe real-world characteristics and treatment patterns of patients with metastatic cutaneous squamous cell carcinoma (mCSCC).

Methods: This retrospective observational study used MarketScan Commercial and Medicare Supplemental claims databases (1/1/2013-7/31/2019). Adult patients with mCSCC who initiated non-immunotherapy systemic treatment (i.e. index event) between 1 January 2014 and 31 December 2018 were assessed for treatment patterns, all-cause and CSCC-related healthcare resource utilization, costs, and mortality .

Results: Overall, 207 patients were included in the study(mean age 64.8 years, 76.3% male), 59.4% had prior radiotherapy, and 58.9% had prior CSCC-related surgery. During follow-up, 75.8%, 51.7%, and 35.7% of patients received chemotherapy, radiotherapy, and targeted therapy as first-line treatment, respectively. Cisplatin (32.9%) and carboplatin (22.7%) were the most common chemotherapy agents, and cetuximab (32.4%) was the most common targeted therapy during the first-line.Probability of death (95% CI) at month 6, year 1, and year 2 was 24% (16-32%), 50% (40 - 59%), and 67% (56 - 75%), respectively. Average CSCC-related healthcare costs were $5,354 per person per month (PPPM), with outpatient costs being the major cost driver at 96.4% ($5,160 PPPM).

Conclusion: During 2014-2018, patients with mCSCC were commonly treated with cisplatin and cetuximab; prognosis was generally poor. These results indicate opportunity for new treatments to improve survival outcomes.

Keywords: healthcare utilization and costs; metastatic cutaneous squamous cell carcinoma; mortality; real-world data; treatment patterns.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell* / drug therapy
  • Cetuximab
  • Cisplatin
  • Female
  • Health Care Costs
  • Humans
  • Male
  • Medicare
  • Middle Aged
  • Retrospective Studies
  • Skin Neoplasms* / pathology
  • Skin Neoplasms* / therapy
  • United States

Substances

  • Cisplatin
  • Cetuximab