Healthcare resource utilization and economic burden of metastatic pancreatic cancer: a US commercial and Medicare claims analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: To assess healthcare resource utilization (HRU) and costs among patients with metastatic pancreatic cancer (mPC). Adult US patients with an mPC diagnosis based on index date 1 January 2020–31 December 2022 were identified in the Merative MarketScan database. All-cause healthcare visits and costs (USD) were estimated per-person-per-month (PPPM) for 1 year post-index period. First-line (1L) treatments (≤90 days post-index) were categorized as FOLFIRINOX (leucovorin, fluorouracil, irinotecan, oxaliplatin)-based, gemcitabine+paclitaxel-based, other, or none. Claims from 2318 patients with mPC were included: 68.6% (1589/2318) with commercial and 31.4% (729/2318) with Medicare. Mean total costs PPPM were $34,215 with commercial and $15,158 with Medicare. A total of 25.7% (409/1589) of commercially insured patients and 43.2% (315/729) of Medicare-insured patients did not receive 1L treatment. Median (interquartile range) cumulative length of stay was 0.8 days (0.1–2.4) with commercial insurance and 0.7 days (0.0–2.4) with Medicare. All-cause PPPM costs were higher for patients without 1L treatment than with 1L treatment in both insurance types, primarily driven by inpatient and outpatient visits. Patients with mPC experienced high economic burden, mostly attributable to inpatient and outpatient costs. The high rate of patients with mPC not receiving 1L treatment merits further exploration. What is this article about? This study looked at how patients with advanced pancreatic cancer in the United States use healthcare and how much their care costs. Researchers used insurance claims data from the Merative MarketScan database to collect data on doctor visits, hospital stays, and emergency department visits, as well as costs associated with those visits for patients with either commercial insurance or Medicare. What were the results? The study found that, among 2318 patients with advanced pancreatic cancer, about 2 in 3 had commercial insurance (69%) while about 1 in 3 had Medicare (31%). On average, monthly healthcare costs were higher for patients with commercial insurance ($34,215) compared with those with Medicare ($15,158). Many patients did not receive first-line treatment (the initial or primary treatment) for their cancer—about 1 in 4 (25.7%) with commercial insurance and more than 2 in 5 (43.2%) with Medicare. Patients with commercial insurance spent longer in hospitals than patients with Medicare (0.8 days vs 0.7 days). For both types of insurance, patients who did not receive first-line treatment needed more inpatient care. What do the results of the study mean? These findings show that patients with advanced pancreatic cancer have high levels of healthcare use and experience high costs. Further investigation is needed to understand why many patients do not receive first-line treatment.
Source: Figshare
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7166887670