DOI: 10.6084/m9.figshare.26779903.v1
title: Real-world treatment patterns, resource utilization and costs in biliary tract cancers in the USA

description: <b>Aim:</b> To evaluate real-world treatment patterns, survival and healthcare-resource utilization in US patients with advanced biliary tract cancers (BTC) receiving systemic therapy. <b>Patients & methods:</b> This study used claims data from the Healthcare Integrated Research Database (HIRD®) linked to clinical data from the Cancer Care Quality Program (January 1, 2015–September 30, 2020). <b>Results:</b> Of 413 patients, 84.5% received gemcitabine-based first-line (1L) treatment, 46% received second-line treatment, and 16.5% received third-line (3L) treatment. All-cause mortality was 53% and approximately 70% of patients had ≥1 inpatient visit. The total mean per-patient-per-month all-cause costs were $19,589 for 1L and $33,534 for 3L treatment. <b>Conclusion:</b> Results showed poor survival, significant resource use and high costs as treatment line progresses for patients with advanced BTC. Our research explored which treatments US patients with advanced biliary tract cancers (BTC) received and how long they lived for. We analyzed information from a US database, called the Healthcare Integrated Research Database (HIRD®), which holds information related to healthcare insurance claims. Out of 413 patients in the database, 84.5% were initially given a combination treatment involving a chemotherapy called gemcitabine. We also found that 46% of patients received a type of second treatment (also known as second-line therapy), and 16.5% received a third treatment (third-line therapy). During treatment, around 70% of patients needed to stay in hospital at least once. The cost of healthcare was more expensive for patients receiving later lines of therapy, with the average monthly cost per patient for first-line treatment being $19,589 and third-line treatment being $33,534. Furthermore, just over half of the 413 patients died from any causes, showing the poor outlook these patients face. This information is important for understanding the real-world management of patients with BTC, so that their care can be improved in the future. This study evaluated real-world treatment patterns, survival, healthcare-resource utilization (HCRU) and costs in patients with advanced biliary tract cancers (BTC) receiving systemic therapy in the US before the recent approval of immuno-oncology (IO)-based regimens. The study was an observational, retrospective cohort study among adults with advanced BTC, identified through medical and pharmacy claims from the Healthcare Integrated Research Database (HIRD®), linked to clinical data from the Cancer Care Quality Program (CCQP). Among 413 patients included in the study, 84.5% of patients received gemcitabine-based first-line (1L) therapy, 46% of patients received a second-line therapy and 16.5% received a third-line (3L) therapy. All-cause mortality was 53% with a median survival of 11.5 months. Approximately 70% of patients had ≥1 inpatient visit and hospitalization was the key driver for HCRU. The total mean per-patient-per-month, all-cause cost increased with progression of line of treatment from 1L treatment ($19,589) to 3L treatment ($33,534). The results highlight poor patient outcomes coupled with high HCRU and costs before the recent approval of IO-based regimens, indicating the need for novel treatment options.