What are major Oncology combination therapies based on claims data?


In Oncology

By: Avinash Kumar  May. 01, 2019

Dexur analyzed Medicare claims data based on a 5% sample for the time period of Jan 2016 to June 2018, to understand the prevalence of oncology combination therapies. This methodology checked for relevant J codes of HCPCS code set in the claim files across the patient’s history. If a patient used a base drug, it was then checked to see what other drugs were used on the same patient.

The three highest combinations of drugs were Herceptin & Perjeta (37.04%), Alimta & Opdivo (21%), Keytruda & Alimta (18.13%). Herceptin was used in combination with Perjeta across the treatment journey in 37% of Herceptin patients. Other drugs used in combination with Herceptin are Kadcyla in 8.86% of patients, and Faslodex in 6.67% of patients at any given day. Opdivo was used in Alimta patients 21.07% of the time. Whereas Alimta was used in Opdivo patients 15.11% of the time.

The analysis also shows that, Avastin was the most used drug in Oncology treatment for Medicare patients based on J Codes. However, it is less used in  combination therapies, when it is a base drug. Top combination drugs used with Avastin are Alimta, Opdivo and Vectibix, with 2.26%, 1.24% and 0.66% patients treated respectively.

Other notable combinations included Velcade & Kyprolis (12.21%), Faslodex & Herceptin (7.79%) & Abraxane & Opdivo (7.75%).

The top 10 drugs that were studied based on Medicare J codes were:

  1. AVASTIN - INJECTION, BEVACIZUMAB, 10 MG - J9035

  2. RITUXAN - INJECTION, RITUXIMAB, 100 MG - J9310

  3. TICE BCG - BCG (INTRAVESICAL) PER INSTILLATION - J9031

  4. OPDIVO - INJECTION, NIVOLUMAB, 1 MG - J9299

  5. ALIMTA - INJECTION, PEMETREXED, 10 MG - J9305

  6. KEYTRUDA - INJECTION, PEMBROLIZUMAB, 1 MG - J9271

  7. ABRAXANE - INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG - J9264

  8. VELCADE - INJECTION, BORTEZOMIB (VELCADE), 0.1 MG - J9041

  9. HERCEPTIN - INJECTION, TRASTUZUMAB, 10 MG - J9355

  10. FASLODEX - INJECTION, FULVESTRANT, 25 MG - J9395

DEXUR PRO MEMBERS:

Dexur Pro members gets access to claims count, top ranked drugs and their combinations data. It also provides a breakdown on disease level data, such as - breast cancer, lung cancer prostate cancer and other indication.

Further, ICD level analysis and quarter over quarter analysis are also available for our research subscribers. Email dexur@dexur.com for details on Oncology drug combination therapies and detailed claims level analysis for the drug of your interest.


ABOUT THE AUTHOR

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Avinash Kumar

Avinash Kumar is a Business analyst with over 9 years of healthcare experience. He has expertise in Real World Evidence (RWE), healthcare claims analytics, market research, data analytics, benefits configuration, claim contractual reprising, adjudication, implementation of reimbursement rule edits for healthcare payers and revenue cycle management for providers. Avinash holds a Master's degree in Operations management and life sciences. He is a certified medical coder from American Association of Professional Coders (AAPC).