Introduction: This study investigated the burden of comorbidities and concomitant non-cancer medications and their cost in patients with neuroendocrine tumors (NETs).
Methods: Adults with gastroenteropancreatic (GEP)-NETs and lung-NETs, with or without carcinoid syndrome (CS), who initiated first-line NET treatment (index date) with a somatostatin analog or telotristat and had ≥ 1 inpatient or ≥ 2 distinct outpatient claims (study period January 1, 2016-December 31, 2022) were identified from the US MarketScan database and matched (age, sex, insurance type) with up to four adults without cancer (reference group). At 0-90 and 91-180 days post-index, medication counts (generalized linear model, GLM), medication frequency distributions (chi-squared test), and medication costs in USD (two-part model: logit model and GLM for the first and second parts, respectively) were assessed. Frequencies of comorbidities of interest (≥ 1 diagnosis claim) in the 6 months post-index were calculated.
Results: A total of 662 patients with GEP-NETs (279 with CS) and 84 with lung-NETs (30 with CS) were included. Irrespective of CS status, mean medication counts in the 0-90 and 91-180 days post-index was 1.5-1.8 times higher for GEP-NETs (p < 0.001) and 1.6-1.9 times higher for lung-NETs (p < 0.005) than reference groups. Medications most frequently prescribed for both NET groups were oral cardiovascular, central nervous system, and gastrointestinal agents. The most common comorbidities of interest in patients with NETs (vs reference groups) were hypertension (GEP-NETs: 68.7% vs 55.0%; lung-NETs: 73.8% vs 58.3%) and type 2 diabetes (GEP-NETs: 35.5% vs 24.1%; lung-NETs: 50.0% vs 28.3%). Excluding anticancer medications, mean per-patient-per-month medication costs (vs reference groups) were $276-811 (vs $176-349) and $390-647 (vs $210-$302) for 0-90 days and 91-180 days post-index, respectively.
Conclusion: Compared with people without cancer, patients with NETs had a higher prevalence of comorbidities and concomitant medication use, which was associated with a greater economic burden.
Keywords: Carcinoid syndrome; Comorbidities; Concomitant medications; GEP-NET; Lung-NET; Neuroendocrine tumor.
Neuroendocrine tumors, or NETs, are a type of cancer that can form in different parts of the body, including the digestive system and lungs. People with NETs often have associated health problems or other medical conditions. Therefore, in addition to their cancer treatment, they may take medications for these other conditions. In this study, researchers compared the other health problems that people with NETs of gastrointestinal, pancreatic, and lung origin have, the medicines they take to treat these health problems, and what these medicines cost, with those of people who did not have cancer. The study found that people with gastrointestinal, pancreatic, or lung-NETs had additional health problems including hypertension and diabetes, and they took more medicines than people without cancer. The medicines that were most used were for the heart, nervous system, and digestive system. On average, the cost of these medicines per patient with gastrointestinal, pancreatic, or lung-NETs was between US $276 and $811 each month; the cost of the medicines per person without cancer was between US $176 and $349 each month. These data suggest that clinicians face a challenge in helping people with NETs when factoring in their other health conditions. To ensure patients get the best care possible, clinicians need to consider medication costs, drug–drug interactions, and overall medication burden when making treatment decisions for patients with NETs.
© 2025. The Author(s).