Real-World Utilization of PARP Inhibitors for Ovarian Cancer in the United States
Study findings suggest differences between available PARP inhibitors in the risk of experiencing a clinical event of interest, likelihood of dose modifications, ability to receive continuous therapy, health care resource utilization (HCRU), and costs, among women with ovarian cancer (Adv Ther. 2021. doi:10.1007/s12325-021-01959-5).
In this study, Rebecca C. Arend, MD, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Alabama at Birmingham, and colleagues aimed to examine the real-world utilization of PARP inhibitor for patients with ovarian cancer in the United States.
US MarketScan Commercial/Medicare Supplemental databases were used to identify women with ovarian cancer initiating treatment with olaparib, niraparib, or rucaparib from January 2017 to May 2019. Patients were observed from first outpatient prescription until at least 30 days of follow-up.
Clinical events of interest, based on adverse reactions in the PARP inhibitor prescribing information, were identified from claims using ICD-9/10 codes. Additional outcomes included dose modification, persistence, adherence, health care resource utilization (HCRU), and cost.
Of the patients included in the study, 303 received olaparib, 348 received niraparib, and 162 received rucaparib. During follow-up, risk of any clinical event of interest was higher with niraparib vs olaparib and niraparib vs rucaparib.
Dose decreases were observed in 21.1% of patients receiving olaparib, 35.1% receiving niraparib, and 30.2% receiving rucaparib. Persistence, defined as no treatment gaps more than 90 days, were observed in 62.2% of patients receiving olaparib, 35.9% receiving niraparib, and 48.7% receiving rucaparib. Treatment adherence was 80.2%, 38.6%, and 63.2%, respectively.
Overall, inpatient admissions and outpatient service use were higher with patients receiving niraparib and rucaparib versus those receiving olaparib. This increase was reflected in mean total medical costs of $5393 for olaparib, $7732 for niraparib, and $6868 for rucaparib.
“This study will help inform physicians and payers of the importance of considering the respective tolerability profiles of PARP [inhibitors], plus the potential downstream implications for treatment adherence/persistence and health economics, when selecting the most appropriate maintenance therapy for patients with [ovarian cancer],” conclude Dr and colleagues.
