Parikh RC, Kurosky S, Kaye JA, Levine C, Hettle R, Shire N, Sawyer W, Wang H. Assessment of treatments and health care utilisation (HCU) in Spain following initial platinum therapy for recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). Poster presented at the ISPOR 21st Annual European Congress; November 14, 2018. Barcelona, Spain.


OBJECTIVES: To assess treatment patterns and HCU among patients with R/M HNSCC in Spain who experienced progression during or after platinum-based chemotherapy.

METHODS: Physicians in Spain recruited by convenience sampling reviewed medical records of adult patients who experienced disease progression between 1 January 2011 and 31 March 2016. Progression must have occurred during or after palliative platinum chemotherapy for R/M HNSCC or within 6 months after platinum chemotherapy as part of a multimodality therapy with curative intent. Disease characteristics, treatment patterns, and HCU (including drug administration encounters) were described.

RESULTS: Data for 196 patients (median age 58.6 years) were extracted by 43 physicians. Second-line systemic therapy was received by 154 (78.6 %) patients; 42 (21.4%) patients received best supportive care only. The most frequently received second-line regimens were cetuximab+paclitaxel (n=38, 24.7%), paclitaxel monotherapy (n=19, 12.3%), and single-agent cetuximab (n=18, 11.7%). Of patients receiving second-line treatment, only 38 (24.7%) received third-line treatment. During second-line treatment, hospital outpatient and community health visits were reported for 64 (41.6%) and 24 (15.6%) patients (median 0.9 and 0.7 visits/month, respectively); 33 (21.4%) patients required emergency department visits, and treatment- or procedure-related complications (n=15, 45.5%) were the most common reason for these visits. Hospitalisations during second-line treatment were reported for 35 (22.7%) patients; median length of stay was 10 days. Palliative care (n=18, 51.4%), disease progression (n=17, 48.6%), and treatment- or procedure-related complications (n=8, 22.9%) were common reasons for hospitalisation.

CONCLUSIONS: After progression on initial platinum therapy, 21.4% patients received best supportive care and, of the 154 (78.6%) receiving second-line therapy, only 24.7% received subsequent treatments. A considerable proportion of patients were hospitalised for disease- and treatment-related issues, highlighting the need for improved safety of new treatments.

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