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Growth of community‐based immunotherapy treatment in the Veterans Health Administration

BACKGROUND: The MISSION and CHOICE Acts expanded the Veterans Health Administration's (VA) capacity to purchase immunotherapy services for VA patients from community‐based providers. Our objective was to identify predictors of community‐based immunotherapy treatment, and assess differences in c...

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Autores principales: Price, Megan Ellis, Gordon, Sarah, Emmitt, Caroline, Ndugga, Nambi, Kabdiyeva, Aigerim, Mull, Hillary, Pizer, Steven, Garrido, Melissa M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10524003/
https://www.ncbi.nlm.nih.gov/pubmed/37519258
http://dx.doi.org/10.1002/cam4.6372
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author Price, Megan Ellis
Gordon, Sarah
Emmitt, Caroline
Ndugga, Nambi
Kabdiyeva, Aigerim
Mull, Hillary
Pizer, Steven
Garrido, Melissa M.
author_facet Price, Megan Ellis
Gordon, Sarah
Emmitt, Caroline
Ndugga, Nambi
Kabdiyeva, Aigerim
Mull, Hillary
Pizer, Steven
Garrido, Melissa M.
author_sort Price, Megan Ellis
collection PubMed
description BACKGROUND: The MISSION and CHOICE Acts expanded the Veterans Health Administration's (VA) capacity to purchase immunotherapy services for VA patients from community‐based providers. Our objective was to identify predictors of community‐based immunotherapy treatment, and assess differences in cost and utilization across community treatment settings METHODS: We examined claims for 21,257 patients who started immunotherapy treatment between 2015 and 2020. We assessed growth in VA community‐based immunotherapy care, predictors of community‐based immunotherapy treatment using multivariable logistic regression based on patients' sociodemographic and clinical characteristics. We compared utilization and costs among those who received community‐based immunotherapy services in hospital outpatient departments (HOPDs) versus physician office settings (POs). RESULTS: The proportion of community‐based immunotherapy in the VA increased from 5.3% in 2015 to 32.1% in 2020, with total annual costs of immunotherapy growing from $6.1 million to $187 million. Older, married, and rural patients and those with more comorbidities were more likely than younger, single, or urban patients to be treated in the community. Black patients were more likely to be treated in the VA. Respiratory Cancer was the most common cancer type in both settings. Among community immunotherapy patients, we observed no meaningful differences in the number of units administered, the unit drug costs, or the cost per immunotherapy visit between POs and HOPDs. CONCLUSION: Drug costs did not differ widely across HOPDs and POs among VA patients who receive community‐based immunotherapy.
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spelling pubmed-105240032023-09-28 Growth of community‐based immunotherapy treatment in the Veterans Health Administration Price, Megan Ellis Gordon, Sarah Emmitt, Caroline Ndugga, Nambi Kabdiyeva, Aigerim Mull, Hillary Pizer, Steven Garrido, Melissa M. Cancer Med RESEARCH ARTICLES BACKGROUND: The MISSION and CHOICE Acts expanded the Veterans Health Administration's (VA) capacity to purchase immunotherapy services for VA patients from community‐based providers. Our objective was to identify predictors of community‐based immunotherapy treatment, and assess differences in cost and utilization across community treatment settings METHODS: We examined claims for 21,257 patients who started immunotherapy treatment between 2015 and 2020. We assessed growth in VA community‐based immunotherapy care, predictors of community‐based immunotherapy treatment using multivariable logistic regression based on patients' sociodemographic and clinical characteristics. We compared utilization and costs among those who received community‐based immunotherapy services in hospital outpatient departments (HOPDs) versus physician office settings (POs). RESULTS: The proportion of community‐based immunotherapy in the VA increased from 5.3% in 2015 to 32.1% in 2020, with total annual costs of immunotherapy growing from $6.1 million to $187 million. Older, married, and rural patients and those with more comorbidities were more likely than younger, single, or urban patients to be treated in the community. Black patients were more likely to be treated in the VA. Respiratory Cancer was the most common cancer type in both settings. Among community immunotherapy patients, we observed no meaningful differences in the number of units administered, the unit drug costs, or the cost per immunotherapy visit between POs and HOPDs. CONCLUSION: Drug costs did not differ widely across HOPDs and POs among VA patients who receive community‐based immunotherapy. John Wiley and Sons Inc. 2023-07-31 /pmc/articles/PMC10524003/ /pubmed/37519258 http://dx.doi.org/10.1002/cam4.6372 Text en Published 2023. This article is a U.S. Government work and is in the public domain in the USA. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle RESEARCH ARTICLES
Price, Megan Ellis
Gordon, Sarah
Emmitt, Caroline
Ndugga, Nambi
Kabdiyeva, Aigerim
Mull, Hillary
Pizer, Steven
Garrido, Melissa M.
Growth of community‐based immunotherapy treatment in the Veterans Health Administration
title Growth of community‐based immunotherapy treatment in the Veterans Health Administration
title_full Growth of community‐based immunotherapy treatment in the Veterans Health Administration
title_fullStr Growth of community‐based immunotherapy treatment in the Veterans Health Administration
title_full_unstemmed Growth of community‐based immunotherapy treatment in the Veterans Health Administration
title_short Growth of community‐based immunotherapy treatment in the Veterans Health Administration
title_sort growth of community‐based immunotherapy treatment in the veterans health administration
topic RESEARCH ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10524003/
https://www.ncbi.nlm.nih.gov/pubmed/37519258
http://dx.doi.org/10.1002/cam4.6372
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