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BioDrugs

, Volume 28, Issue 2, pp 229–236 | Cite as

Systemic Therapy for Colorectal Cancer: Patterns of Chemotherapy and Biologic Therapy Use in Nationally Representative US Claims Database

  • Brian S. Seal
  • Sean D. Sullivan
  • Scott D. Ramsey
  • Kenneth M. Shermock
  • Jinma Ren
  • Charlie Kreilick
  • Susan Boklage
  • Satish Valluri
  • Syam Sarma
  • Carl V. Asche
Original Research Article

Abstract

Background

Treatment strategies for colorectal cancer (CRC) are highly variable. The aim of this study is to examine the patterns of chemotherapy and biologic therapy use for CRC patients in a national medical claims database.

Methods

A retrospective and observational analysis was performed using the i3 Innovus claims database to identify healthcare services consumed by patients aged 18 years and older, diagnosed with CRC between 1 January 2005 and 30 June 2009 in commercial health plans.

Results

Of 9,876 subjects diagnosed with CRC, fluorouracil (23.5 %) and capecitabine (10.0 %) were the dominant first-line monotherapies, followed by bevacizumab (3.2 %) and oxaliplatin (2.9 %). The most common combination regimen at first line and first and second line was FOLFOX (fluorouracil, leucovorin, and oxaliplatin; more than 25 %). The combinations FOLFIRI (fluorouracil, leucovorin, and irinotecan) plus bevacizumab (14.2 %) and FOLFOX plus bevacizumab (13.9 %) were significantly more frequent in third and successive lines of CRC therapy than other regimens (χ2 = 191.2; P < 0.01). Additionally, the average annualized cost of CRC treatment for all patients was $US66,452, and the adjusted analysis demonstrated that patients receiving FOLFOX-A (FOLFOX + avastin) or FOLFIRI-A (FOLFIRI + avastin) had higher costs for CRC treatment.

Conclusions

With the exception of a sizeable portion of patients on monotherapy, the treatment patterns for CRC were largely consistent with National Comprehensive Cancer Network (NCCN) guidelines.

Keywords

Bevacizumab Irinotecan Oxaliplatin Capecitabine Cetuximab 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments and Disclosures

Drs. Sullivan, Ramsey, Asche, Shermock, Kreilick, Boklage, Ren, and Syam are consultants to Bayer. Brian Seal and Satish Valluri were employees of Bayer.

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Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  • Brian S. Seal
    • 1
  • Sean D. Sullivan
    • 2
    • 3
  • Scott D. Ramsey
    • 2
    • 3
  • Kenneth M. Shermock
    • 4
  • Jinma Ren
    • 5
  • Charlie Kreilick
    • 1
  • Susan Boklage
    • 1
  • Satish Valluri
    • 1
  • Syam Sarma
    • 6
  • Carl V. Asche
    • 5
    • 7
  1. 1.Bayer HealthCare Pharmaceuticals Inc.WayneUSA
  2. 2.University of WashingtonSeattleUSA
  3. 3.Fred Hutchinson Cancer Research CenterSeattleUSA
  4. 4.Analysis by Design, LLCColumbiaUSA
  5. 5.University of IllinoisChicagoUSA
  6. 6.Syam SarmaWilmingtonUSA
  7. 7.Center for Outcomes ResearchUniversity of Illinois College of Medicine at PeoriaPeoriaUSA

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