title: Economic burden of dermatologic adverse drug reactions in the treatment of colorectal, non-small cell lung, and head and neck cancers with epidermal growth factor receptor inhibitors.
abstract: BACKGROUND
  Patients treated with epidermal growth factor receptor inhibitors (EGFRIs) may develop dermatologic adverse drug reactions (ADRs) that may affect patients' quality-of-life, require medical care, and may lead to substantial costs. This study assessed the economic burden of dermatologic ADRs in colorectal cancer (CRC), head and neck cancer (HNC), and non-small cell lung cancer (NSCLC) patients.
  
  
  METHODS
  Adult patients with ≥1 diagnosis for the study cancer initiated on EGFRIs indicated for CRC, HNC, and NSCLC were selected from a large commercial database (MarketScan Commercial Database [2000-2010]; Thomas Reuters, New York, NY). For each cancer type, patients were classified into two mutually exclusive cohorts: 'ADR' (patients with ≥1 ADR following EGFRI initiation) and 'ADR-free' (patients without any ADR). Patients were observed from the index date up to the end of continuous healthcare plan enrollment or 90 days after EGFRI discontinuation, whichever occurred first. For each cancer group, the proportion of patients and the incidence rate (IR) of experiencing ≥1 dermatologic ADR were reported. Incidence rate ratios for healthcare resource utilization and monthly incremental costs (2010 USD) were estimated using Poisson regression and generalized linear or two-part models, respectively.
  
  
  RESULTS
  Overall, the proportion of patients with ≥1 ADR ranged between 20.5-36.4% across cancer groups (IR ranged between 44.2-57.4 per 100 patient-years). After adjusting for confounders, in each cancer group, ADR patients had higher incidence of healthcare resource utilization, generally driven by higher incidence of emergency room visits and incurred incremental total monthly healthcare costs that ranged between $2284-$3210 across cancer groups.
  
  
  CONCLUSIONS
  There was no clinical measure of cancer staging and ADR severity in the database.
  
  
  CONCLUSIONS
  Results suggest that patients with CRC, NSCLC, and HNC, who may benefit from EGFRI therapies, may also incur a substantial economic burden that is associated with dermatologic ADRs.
authors.affiliation: Abbott Laboratories, Abbott Park, IL, USA.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Ray
authors.forename: Vijayveer
authors.initials: V
authors.lastname: Bonthapally
authors.forename: Kyle D
authors.initials: KD
authors.lastname: Holen
authors.forename: Geneviève
authors.initials: G
authors.lastname: Gauthier
authors.forename: Eric Q
authors.initials: EQ
authors.lastname: Wu
authors.forename: Martin
authors.initials: M
authors.lastname: Cloutier
authors.forename: Annie
authors.initials: A
authors.lastname: Guérin
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D017281:Cost of Illness; D003875:Drug Eruptions / Q000191:economics*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D066246:ErbB Receptors