Barber, BL

Chen, Y

Hines, DM

Ma, Q

Munakata, J

Zhao, Z

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PCN353 Current Treatment Patterns In Patients With Metastatic Melanoma: A Retrospective Claims Database Analysis In The United States (Us) 

A492  VA L U E  I N  H E A LT H  1 8  ( 2 0 1 5 )  A 3 3 5 – A 7 6 6  
fees under the routine continuous chemotherapies were RMB11,333 (USD1,828) per 
patient, with 34.8% (RMB3,939) born by the patient out-of-pocket. Under PAP, for the 
same patient group, the patients monthly self-paid RMB4,519 (USD729) of the aver-
age fees for Icotinib and another RMB1,064 (USD172, 16.9% of total fees) for other 
drugs and routine treatment. ConClusions: The PAP, which provides the targeted 
patients the access to innovative medicines with better efficacy and safety, greatly 
decreased the fees on routine treatment, but also brought additional self-paid cost 
on PAP-covered medicines. Further researches are needed to help decision makers 
to make the tradeoff among better accessibility, increasing cost and improved out-
comes from the clinical utilization of PAP-covered innovative medicines.
PCN352
PatieNt CharaCteristiCs aNd treatmeNt PatterNs iN er+/her2- 
metastatiC Breast CaNCer iN the Uk: resUlts From a retrosPeCtive 
mediCal reCord review
Kurosky S1, Mitra D2, Zanotti G2, Kaye JA3
1RTI Health Solutions, Research Triangle Park, NC, USA, 2Pfizer, Inc., New York, NY, USA, 3RTI 
Health Solutions, Waltham, MA, USA
objeCtives: To describe demographic and clinical characteristics and real-world 
treatment patterns for post-menopausal patients with ER+/HER2- metastatic breast 
cancer (MBC) in the United Kingdom (UK). Methods: We conducted a retrospective 
review of medical records from institutions across the UK. Records were eligible for 
abstraction if patients were post-menopausal, had ER+/HER2- MBC (stage IV), and 
had discontinued second-line treatment in the metastatic setting between 1/1/2008 
and 3/1/2014. Patients who participated in clinical trials were excluded. This study 
was considered a “Service Evaluation” by National Research Ethical Service guid-
ance, thus ethics review was not required. Patient demographic, clinical character-
istics and treatment patterns including time to progression (TTP) and treatment 
discontinuation were assessed. Results: Forty-one medical/ clinical oncologists 
provided information for 209 patients. Patients were aged 62 years on average and 
predominantly Caucasian (87%), with 68% diagnosed in metastatic stage and 32% 
progressed from earlier stages. Bone was the most common site of metastasis (66%) 
followed by lung/pleura (50%), liver (41%), and lymph nodes (35%). In the first-line 
MBC setting, 49% of patients received endocrine therapy alone, 6% received it in 
combination with chemotherapy, 15% received it following chemotherapy induction, 
and 30% received chemotherapy alone. Chemotherapy usage increased in subse-
quent therapy lines (33% in second-line [n= 209]; 53% in third-line [n= 116]). Disease 
progression was the primary reason for discontinuing treatment in both first- and 
second-line (60% and 68% respectively). During first-line treatment, 86% progressed, 
with median TTP of 9.5 months. In second-line, 79% progressed, with median TTP of 
7 months. ConClusions: Endocrine therapy and chemotherapy were commonly 
prescribed for ER+/HER2- MBC patients. Disease progression remains the most com-
mon reason for stopping/ changing therapies, with median TTP < 1 year. These 
findings suggest that there is a continuing unmet need for new treatments that can 
extend TTP and address the potential limitations of current therapies.
PCN353
CUrreNt treatmeNt PatterNs iN PatieNts with metastatiC 
melaNoma: a retrosPeCtive Claims dataBase aNalysis iN the UNited 
states (Us)
Chen Y1, Ma Q2, Hines DM1, Zhao Z2, Munakata J3, Barber BL2
1IMS Health, Fairfax, VA, USA, 2Amgen Inc, Thousand Oaks, CA, USA, 3IMS Health, San Francisco, 
CA, USA
objeCtives: To describe the real-world treatment patterns of current melanoma 
therapies among patients with metastatic melanoma in the US. Methods: A ret-
rospective cohort analysis was conducted using the IMS PharMetrics Plus claims 
database. Patients were included in the analysis if: ≥ 1 prescription for ipilimumab, 
vemurafenib, temozolomide, or dacarbazine between 1/1/2011-8/31/2013 (the date 
of the first use as the index date and the drug as the index drug); diagnosis of 
melanoma (ICD-9-CM 172.x, V10.82) and metastasis (ICD-9-CM 196.x-198.x) before 
the index date (pre-index); no index drug use pre-index date; continuous health 
plan enrollment for ≥ 6 months before and ≥ 3 months after the index date; age ≥ 18 
years. Treatment duration was assessed from the index date until a gap in days 
supplied for > 90 days, or the end of follow-up, whichever came first. Proportion 
of days covered (PDC) was defined as days exposed to the index therapy divided 
by continuously-enrolled days between the index date and the last prescription 
date of the index drug. Results: 1,043 patients with metastatic melanoma were 
included, with a median age of 57 years (43% ≤ 55 years), and 62% male. 405 patients 
received the index drug of ipilimumab, 361 vemurafenib, 203 temozolomide, and 
74 dacarbazine. Mean (median) treatment duration with vemurafenib, temozolo-
mide and dacarbazine was 174 (148), 100 (59) and 64 (52) days, respectively. Mean 
PDC with vemurafenib, temozolomide and dacarbazine was 81%, 67% and 51%, 
respectively. For patients receiving ipilimumab, 58% (234/405) had the full 4 doses, 
20% (79/405) had 3 doses only, 14% (57/405) had 2 doses only, and 9% (35/405) had 1 
dose only for the first treatment course; 4% (10/234) received re-treatment, and no 
patients had a second re-treatment. ConClusions: This study provides evidence 
of current treatment patterns of melanoma therapies, including newer agents, in 
the real-world clinical practice.
PCN354
treatmeNt PatterNs amoNg FroNt-liNe glioBlastoma PatieNts iN 
Five eUroPeaN CoUNtries
Jiang S1, Hill K2, Patel D1, Worthington K2
1Pharmerit International, Bethesda, MD, USA, 2Celldex Therapeutics, Hampton, NJ, USA
objeCtives: To characterize real-world treatment patterns among front-
line patients with glioblastoma in Germany, France, Italy, UK, and Spain (EU-
5). Methods: This study used the oncologist-surveyed data from the IMS LifeLink™ 
Oncology Analyzer database. Front-line patients aged ≥ 20 years and diagnosed 
with glioblastoma during 2012 to 2014 in the EU-5 countries were included. Patient 
PCN349
evalUatioN oF a PaymeNt By resUlts sCheme iN a CatalaN CaNCer 
CeNter: geFiNitiB iN egFr mUtatioN-Positive advaNCed NoN-small 
Cell lUNg CaNCer
Simon S1, Clopes A2, Gasol-Boncompte M3, Cajal R4, Segu JL5, Crespo R2, Mora-Ripoll R6, 
Cordero L7, Calle C2, Gilabert-Perramon A8, Germa JR9
1Astrazeneca Farmaceutica, S.A., Madrid, Spain, 2Institut Catala d’Oncologia, Barcelona, Spain, 
3CatSalut, Barcelona, Spain, 4AstraZeneca Spain, Madrid, Spain, 5Oblikue Consulting, Barcelona, 
Spain, 6CatSalut, Catalan Health Service, Barcelona, Spain, 7Astrazeneca, Madrid, Spain, 
8Government of Catalonia, Barcelona, Spain, 9Institu Catala D’Oncologia, Hospitalet de Llobregat, 
Barcelona, Spain
objeCtives: To evaluate the economic results of this PbR compared to a traditional 
purchasing model and determine the perception of the stakeholders involved in 
the agreement. In healthcare systems, incentive-based schemes generally called 
payment-by-results schemes (PbR), which dynamically link the price of innovation 
to the usage conditions are alternatives to traditional fixed payment schemes. 
In 2011, the first PbR in Catalonia was signed between the Catalan Institute of 
Oncology, the Catalan Health Service and AstraZeneca (AZ) for the introduction 
of gefitinib in the treatment of EGFR-mutation positive advanced non-small-cell 
lung cancer. Methods: Economic analysis of the differential costs between two 
scenarios, one including the total cost of treatment and the PbR scenario where 
AZ reimbursed the treatment according to previously agreed terms. 41 patients 
were included from June 2011 to October 2013 and assessed at two evaluation 
points. At week 8, responses, stabilization and progression were evaluated and 
at week 16 stabilization was confirmed. AZ was to reimburse the total cost of 
treatment of those patients that failed the treatment. A qualitative research of 
the organizational elements was done by interviewing the parties involved in the 
contract Results: The difference in cost of gefinitib using the PbR compared to 
the traditional purchasing scenario was 6.17% less at 8 weeks, 11.18% at 16 weeks 
and 4.15% less for the overall treatment. The PbR resulted in total savings of around 
€ 36,000, which corresponds to approximately € 1,000 per patient. From an opera-
tional and organizational perspective, the availability of adequate information 
systems to measure outcomes and monitor accountability and the involvement of 
healthcare professionals were acknowledged as crucial. ConClusions: The par-
ties have identified tangible and intangible benefits with respect to the interests 
of the parties involved. This has led to the incorporation of innovation for patients 
under acceptable conditions.
PCN350
exPloriNg BeFore aNd aFter risk-shariNg sCheme imPlemeNtatioN 
dUriNg 8.5 years FoCUsed oN aNtiCaNCer drUgs
Chae JY, Park HK, So SM
Health Insurance Review & Assessment Service (HIRA), Seoul, South Korea
objeCtives: Risk-sharing scheme (RSS) has been implemented since Nov 2013 
as part of policies to increase patients’ accessibility in Korea. This study aimed 
to compare the impact of reimbursement rate before and after the implementa-
tion of RSS especially in anticancer drugs and to review the characteristics of the 
anticancer drugs on risk-sharing agreement (RSA). Methods: Reviewed appraisal 
results for anticancer drugs in HIRA Drug Reimbursement Assessment Committee 
from 2007 to Jun 2015. The rate of reimbursement recommendation before and after 
RSS implementation and the proportion of RSA after RSS implementation were 
assessed. Drugs recommended after RSS implementation were classified into com-
parative clinical effectiveness-superior, non-inferior, similar- and cost effectiveness-
assessed by economic analysis or weighted average price. From each category, the 
proportion of RSA drug and type of scheme were counted. Results: During 8.5 
years, total 86 appraisals of anticancer drugs, the reimbursement recommendation 
rate was 58.1%(50/86). The reimbursement recommendation rate was 55.4%(31/56) 
before RSS implementation and 63.3%(19/30) after RSS implementation. After RSS 
implementation, 19 appraisals of anticancer drugs were reimbursement, 10 of them 
were reimbursement on the condition of RSA (53%), and types of RSS were refund 
(100%). As for comparative clinical effectiveness of among 19 appraisals after RSS 
implementation, 16 were superior, 3 were silimilar to comparator. Among ‘superior’ 
group, 12 were assessed by economic analysis (CUA), 6 of them were on RSA (50%). 
The number of appraisals not assessed by economic analysis in superior group was 
4, and they were on RSA. In ‘similar’ group, all were assessed by weighted average 
price and none of them were on RSA. ConClusions: The implementation of RSS 
seemed to contribute to increase patients’ accessibility to new anticancer drugs. RSS 
can be a compensating way to decision-making for reimbursement of anticancer 
drugs which are clinically beneficial but having uncertainty in cost-effectiveness.
PCN351
aCCess to iNNovatioN aNd eCoNomiC BUrdeN----a Case oF NoN-small 
Cell lUNg CaNCer iN a PatieNt aCCess Program iN QiNgdao, ChiNa
Chen W, Lin Y, Zhang L
Fudan University, Shanghai, China
objeCtives: A patient access program (PAP) was adopted by local health insur-
ance scheme in Qingdao since 2012 to provide the coverage of innovative products 
for catastrophic diseases including non-small cell lung cancer. This study aims to 
measure the impact of PAP on economic burden of the patients with non-small cell 
lung cancer. Methods: The patients with non-small cell lung cancer during 2008 
and 2013 were identified from health insurance information system. All claims data, 
including total treatment fees, the composition and the out-of-pocket fees born by 
the patients, were collected and a comparative analysis before and after the PAP 
implementation was conducted. Results: The PAP was achieved through price 
negotiation between local health insurance agent and manufacturers and reim-
bursed 70% of the cost of PAP-covered innovative medicines including Icotinib for 
non-small cell lung cancer. Totally 299 new patients with non-small cell lung cancer 
registered in PAP and another 78 patients were identified to switch from routine 
chemotherapies into Icotinib regimen. Before PAP, the average monthly treatment 


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PCN353 Current Treatment Patterns In Patients With Metastatic Melanoma: A Retrospective Claims Database Analysis In The United States (Us)

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