Table 5.
Multivariable-adjusted Relative Cost Ratiosa for Associations between Race, Diagnosis Year, and Total 12-month OAA-specific Costs to Medicare, Total 12-month OAA-specific Patient Out-of-Pocket Costs, Medicare cost for the Patient’s First OAA Prescription, and Out-of-Pocket Costs for the Patient’s First OAA Prescription
| Parameter | Multivariable-adjusted Relative Cost Ratiosb RCR (95%CI) | |
| Cost to Medicare | Patient out-of-pocket costs | |
| Total OAA costs in 12 months post-DX | ||
| Race (ref. White Non-Hispanic) | ||
| Black Non-Hispanic | 1.02 (0.87–1.20) | 0.46 (0.30–0.72) |
| Hispanic | 1.05 (0.94–1.18) | 0.46 (0.34–0.62) |
| Other | 1.00 (0.88–1.14) | 0.43 (0.30–0.60) |
| Drug prescribed at first fill (ref. Sunitinib) | ||
| Sorafenib | 0.86 (0.76–0.98) | 0.65 (0.47–0.91) |
| Pazopanib | 0.75 (0.69–0.81) | 0.91 (0.73–1.13) |
| Everolimus | 0.96 (0.81–1.14) | 3.34 (1.84–6.08) |
| Axitinib | 1.03 (0.80–1.31) | 0.80 (0.43–1.51) |
| Year of metastatic diagnosis | ||
| 1 year increase | 1.06 (1.05–1.08) | 0.90 (0.86–0.93) |
| Cost for patient’s first OAA fill standardized to a 30-day supply | ||
| Race (ref. White Non-Hispanic) | ||
| Black Non-Hispanic | 1.05 (0.89–1.24) | 0.45 (0.29–0.69) |
| Hispanic | 1.13 (1.00–1.28) | 0.31 (0.24–0.41) |
| Other | 1.03 (0.90–1.19) | 0.31 (0.22–0.42) |
| Drug prescribed at first fill (ref. Sunitinib) | ||
| Sorafenib | 0.81 (0.70–0.93) | 0.69 (0.51–0.94) |
| Pazopanib | 0.59 (0.54–0.64) | 0.77 (0.62–0.95) |
| Everolimus | 0.97 (0.81–1.17) | 3.69 (2.07–6.56) |
| Axitinib | 0.92 (0.71–1.18) | 0.77 (0.41–1.43) |
| Year of metastatic diagnosis | ||
| 1 year increase | 1.06 (1.04–1.08) | 0.91 (0.88–0.95) |
aLimited to patients initiating an OAA. bMultivariable models additionally adjusted for patient age, sex, cancer stage at initial diagnosis, tumor histology, region of residence, residence in metropolitan area, Medicaid dual enrollment status, zip code characteristics, patient comorbidities, and patient’s prior year total Medicare spending.