Treatment Patterns and Economic Burden of Chinese Metastatic Colorectal Cancer Patients: a Retrospective Study of Electronic Medical Records from Urban China

To describe treatment patterns and economic burdens of metastatic colorectal cancer (mCRC) in real-world practice of China. Electronic medical records (EMRs) between 1st Jan 2011 to 30th Sep 2016 sourced from 12 tertiary hospitals in urban China were extracted. Among them, patients who aged over 18 years at mCRC diagnosis, received at least three lines of palliative chemotherapy and initiated 3rd-line treatment before 1st Jan 2016 were included. Patient characteristics at baseline, treatments and relevant costs during inpatient admissions were documented in EMRs, and descriptive statistics were used. Costs were discounted to year 2016. A total of 404 patients were identified, with a median age at 56 years (Q1 – Q3: 47 – 64). Patients received a median of 6 cycles at 1st-line, 4 at 2nd-line and only 2 at 3rd-line. Oxaliplatin- and irinotecan-based regimens dominated 1st- and 2nd-line respectively (44.31% and 37.38%), but no chemotherapy regimen dominated 3rd-line. Not many patients received targeted biologics at 1st- and 2nd-line (18.07%, 12.37% respectively), but the number increased at 3rd-line (33.91%). Mean total medical costs per cycle were $2678.89 and $2811.75 at 1st- and 2nd-line respectively, and increased dramatically at 3rd-line to $5381.08. Patients receiving targeted biologics in combination with chemotherapy spent more than those receiving chemotherapy alone, and their mean medical costs per cycle increased from $3507.93 and $2843.52 at 1st- and 2nd-line to $6848.72 at 3rd-line. In China, clear treatment patterns for mCRC patients could be seen at 1st- and 2nd-line but not at 3rd-line. Compared to earlier lines, 3rd-line treatment did not last long but costs per cycle were extremely high, suggesting better treatments are warranted. Besides, targeted biologics were not much used in earlier lines where the costs per cycle were relatively low; therefore earlier use of targeted biologics may help reduce overall economic burden.