Monoclonal Antibodies in Cancer Care: Is Underinsurance An Access Barrier?

单克隆抗体在癌症治疗中的应用：保险不足是准入障碍吗？

• 批准号: 7786445
• 负责人: Ya-Chen Tina Shih
• 金额: $ 45.62万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7786445
• 关键词: Monoclonal; Antibodies; Cancer; Care; Underinsurance

DESCRIPTION (Provided by the Applicant): The high costs associated with several innovative cancer therapies, most notably monoclonal antibodies (mAbs), have raised a concern that even among cancer patients with insurance, mAbs may be financially unaffordable due to the associated high out-of-pocket payment. Such high costs create a vulnerable group of cancer patients known as the "under-insured." The objectives of our study are to use claims data to examine the diffusion of innovative monoclonal antibody agents among cancer patients younger than 65 years who have private insurance; to explore whether underinsurance may constitute a barrier to the access of these novel therapies; and to determine their impact on the costs of cancer care. The study has five specific aims: (1) to describe the trend of mAb use among non-elderly cancer patients with private insurance; (2) to examine whether mAb utilization patterns differ by patient characteristics and/or insurance generosity in the types of cancer with approved indication for mAb use; (3) to estimate the impact of mAbs on the costs of cancer care and cost increases over time in the types of cancer with approved indication for mAb use; (4) to determine factors associated with off-label mAb use; (5) to estimate the overall costs of cancer care and cost increases over time and to ascertain the associated cost drivers. For each study aim, appropriate econometric methods will be applied to analyze factors associated with mAb use, and cancer treatment costs. Separate analyses will be performed for all cancers, and for each of the three cancer sites that are most likely to be treated with mAbs: non-Hodgkin's lymphoma, colorectal cancer, and breast cancer. As immunotherapy, in particular, mAbs, becomes increasingly important in cancer care, this study will inform policymakers of the diffusion of recent therapeutic innovations among cancer patients and the impact of innovative agents such as mAbs on the costs of cancer care. This information will help project the future costs of cancer. Findings from this study will also alert policymakers to the subgroups of patients who may not benefit from innovative agents such as mAbs due to access barriers.

描述（由申请人提供）：与几种创新的癌症疗法相关的高成本，最著名的是单克隆抗体（MABS），引起了人们的担忧，即即使在有保险的癌症患者中，MAB在经济上也可能无法承受，这是由于相关的高费付费支付。如此高昂的成本造成了一组脆弱的癌症患者，称为“保险不足”。我们研究的目的是使用索赔数据来检查创新的单克隆抗体剂在65岁以下的私人保险的癌症患者中的扩散；探索不足的保险是否可能构成这些新型疗法的障碍；并确定它们对癌症护理成本的影响。该研究具有五个具体的目的：（1）描述非私人保险的非大型癌症患者中使用mAb的趋势； （2）检查MAB利用模式是否因患者特征和/或保险范围的癌症类型而有所不同，并批准了MAB使用的指示； （3）估计mAb对癌症护理成本的影响，并且在癌症类型中随着时间的推移而增加了MAB使用的指示； （4）确定与标签不使用的因素相关的因素； （5）估计癌症护理的总体成本和成本随着时间的流逝而增加，并确定相关的成本驱动因素。对于每个研究的目的，将采用适当的计量经济学方法来分析与使用MAB使用和癌症治疗成本相关的因素。将对所有癌症进行单独的分析，以及最有可能用MAB治疗的三种癌症部位中的每个分析：非霍奇金的淋巴瘤，大肠癌和乳腺癌。由于免疫疗法尤其是mAB，在癌症护理中变得越来越重要，本研究将为决策者提供癌症患者最近治疗创新的扩散以及MABS（例如mAB）对癌症护理成本的影响。这些信息将有助于预测癌症的未来成本。这项研究的发现还将警告决策者对可能因障碍而无法受益的患者的亚组。