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Higher Out-of-Pocket Costs Associated With Decreased TKI Adherence in NSCLC

February 15, 2021

Higher out-of-pocket (OOP) costs for tyrosine kinase inhibitors (TKIs) among patients with epidermal growth factor receptor (EGFR)- and anaplastic lymphoma kinase (ALK)-positive advanced non–small-cell lung cancer (NSCLC) are associated with decreased adherence and overall survival (OS; JCO Oncol Pract. 2020;OP2000692. doi:10.1200/OP.20.00692).

Researchers used the Hutchinson Institute for Cancer Outcomes Research registry-claims database to identify patients with stage IV EGFR- or ALK-positive NSCLC. Average monthly TKI OOP costs per patient were estimated and compared to TKI duration of therapy, TKI adherence, and TKI discontinuation.

Patients with higher OOP costs were more likely to have inferior OS (adjusted hazard ratio [HR], 1.85; [95% CI, 1.11 to 3.10], decreased TKI adherence (adjusted odds ratio [OR], 0.28; 95% CI, 0.10 to 0.76), and higher TKI discontinuation rate (adjusted OR, 8.75; 95% CI, 2.59 to 29.52).

“Among patients with advanced EGFR- and ALK-positive NSCLC, higher TKI OOP costs are associated with decreased TKI adherence, a higher likelihood of TKI discontinuation, and inferior survival,” concluded Bernardo Goulart, MD, Hutchinson Institute for Cancer Outcomes Research (HICOR), Fred Hutchinson Cancer Research Center, University of Washington, Department of Medicine, Division of Medical Oncology (Seattle, WA) and colleagues.—Lisa Kuhns

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