title: Chemotherapy treatment patterns, costs, and outcomes of patients with gastric cancer in the United States: a retrospective analysis of electronic medical record (EMR) and administrative claims data.
abstract: BACKGROUND
  The aim of this study was to conduct a retrospective database analysis to describe the chemotherapy treatment patterns and outcomes of patients with gastric cancer.
  
  
  METHODS
  Individuals diagnosed with gastric cancer were identified from the IMS Oncology Database, which contains electronic medical record (EMR) data collected from a variety of community practices, and the Truven Health MarketScan(®) Research database, an administrative claims database. Eligible patients were 18 years of age or older and had an ICD-9 code 151.0-151.9. Patients were excluded if they had evidence of cancer within 6 months of the index diagnosis.
  
  
  RESULTS
  There were 5257 eligible patients identified in EMR data: 1982 (37.7 %) of these patients also had data regarding chemotherapy treatments. Of the 1982 patients who received first-line therapy, 42.3 %, 18.1 %, and 7.9 % went on to receive a second, third, and fourth line of chemotherapy, respectively. There were 11891 eligible patients identified in the administrative database; 5299 (44.6 %) had data regarding chemotherapy. Of those initiating chemotherapy, 2888 (54.5 %) received a second line and 1598 (30.2 %) received a third line of treatment. The average total cost of care during first-line therapy was $40,811 [standard deviation (SD) = $49,916], which was incurred over an average of 53.5 (SD = 63.4) days. A similar pattern was evident in second-line treatment (mean/SD, $26,588/$33,301) over 41.2 (SD = 55.7) days.
  
  
  CONCLUSIONS
  Costs and duration of care received vary among gastric cancer patients in the U.S. There is a need to understand which regimens may be associated with better health outcomes and to standardize treatment as appropriate.
authors: Eli Lilly and Company, Indianapolis, IN, 46285, USA. hess_lisa_m@lilly.com.
authors: Lisa M
authors: LM
authors: Hess
authors: Eli Lilly and Company, Indianapolis, IN, 46285, USA.
authors: Diane
authors: D
authors: Michael
authors: Eli Lilly and Company, Indianapolis, IN, 46285, USA.
authors: Daniel S
authors: DS
authors: Mytelka
authors: Eli Lilly and Company, Indianapolis, IN, 46285, USA.
authors: Julie
authors: J
authors: Beyrer
authors: Eli Lilly and Company, Indianapolis, IN, 46285, USA.
authors: Astra M
authors: AM
authors: Liepa
authors: Eli Lilly and Company, Indianapolis, IN, 46285, USA.
authors: Steven
authors: S
authors: Nicol
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D016208:Databases, Factual; D004358:Drug Therapy / Q000191:economics* / Q000379:methods; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000191:economics; D016896:Treatment Outcome; D014481:United States
keywords: Economics, medical; Outcome assessment; Retrospective studies; Stomach neoplasms