BACKGROUND

1. Utilization Patterns of Erythropoiesis Stimulating Agents Prescribed for Chemotherapy-Induced Anemia, and the Impact of the Outpatient Regimen on Subsequent Inpatient Use: A Pilot Study. John Reitan, PharmD;1 Arletta van Breda, RN;1 Patricia Corey-Lisle, PhD, RN;2 Ze Cong, PhD;2 Sanatan Shreay, PhD2.  1 RJM Group, LLC ; 2 Amgen Inc. RESULTS BACKGROUND RESULTS • Supportive therapy to treat anemia due to concomitantly administered myelosuppressive chemotherapy (CIA) with erythropoiesis stimulating agents (ESAs) involves considerable resource utilization. • ESA regimens that decrease the number of interventions needed to maintain adequate hemoglobin may be beneficial for clinicians and patients. • A total of 312 patients were eligible for inclusion (219: Q3W, 93: QW). • Age and duration of follow-up were similar for the Q3W and QW groups. • The mean number of outpatient ESA doses per patient was lower among patients on the Q3W schedule (4.4 versus 8.3, p<0.01). • The number of hemoglobin determinations were also lower among patients on the Q3W schedule (12.3 versus 14.6, p=0.03). • There was no difference in mean pre-ESA hemoglobin (9.9g/dl for both groups). • Patients receiving ESAs on a QW schedule twice as likely to receive at least one inpatient ESA dose (15% versus 7%, p=0.05). • The number of inpatient ESA doses was 27 per 100 patients receiving the QW regimen versus 8 per 100 patients receiving the Q3W regimen (p=0.04). OBJECTIVES • The primary objective is to characterize ESA usage in institutional outpatient oncology centers that have included every week (QW) and every-three-weeks (Q3W) ESA dosing in their outpatient ESA guidelines, and to describe the frequency of ESA doses, and hemoglobin determinations during courses of ESA therapy. • A secondary objective is to compare rates at which inpatient ESA doses are administered to patients receiving ESAs on QW versus Q3W schedules. CONCLUSIONS METHODS • In this pilot study of outpatient ESA use, it appears that the use of longer-acting ESAs (Q3W) may be associated with reduced frequencies of 1) hemoglobin determinations and 2) ESA doses required. • Q3W dosing may reduce inpatient utilization of ESAs, by reducing the number of ESA doses required for previously maintained outpatients. • As this was a pilot investigation, further scrutiny of these findings, with a larger study is warranted. • Study Description: • Retrospective observational record review. • Conducted in 2 outpatient cancer clinics in the Mid-Atlantic and Southeast United States. • Selection of Participants: • Eligible sites are those using ESAs on both QW and Q3W schedules. • Eligible patients are those >18 years of age, receiving chemotherapy for a solid tumor, who initiated an ESA regimen between August 1, 2007 and June 30, 2009. • Data Collection • Follow-up continued as long as the patient was maintained on his/her original ESA regimen, or until death, change to an alternative ESA schedule, or termination of the ESA course (i.e., 42 days elapsed since the last ESA dose). • All inpatient admissions were noted, and inpatient ESA dosing, hemoglobin and transfusion administration were recorded from the inpatient record. • Statistical Analysis: • Baseline characteristics were compared using using Student’s t-test, Chi Squared, or Wilcoxon rank sum test, as appropriate. • Differences in rates of utilization between QW and Q3W groups were assessed using Student’s t-test or Chi Squared, as appropriate. DISCLOSURES Authors of this presentation have the following to disclose concerning possible financial or personal relationships with commercial entities that may have a direct or indirect interest in the subject matter of this presentation: John Reitan: Nothing to disclose Arletta van Breda: Nothing to disclose Patricia Corey-Lisle: Employee and stockholder ‐ Amgen, Inc. Ze Cong: Employee and stockholder ‐ Amgen, Inc. Sanatan Shreay: Employee and stockholder ‐ Amgen, Inc.