{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T04:27:53Z","timestamp":1765772873611,"version":"3.41.2"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T00:00:00Z","timestamp":1630972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014091","name":"AstraZeneca Pharma Poland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014091","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hepatocellular carcinoma (HCC) is an aggressive form of liver cancer with increasing incidence and mortality worldwide. For metastatic disease, systemic treatment is recommended. In addition to tumor characteristics, adverse events (AEs) may influence regimen choice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To analyze healthcare burden among patients with advanced HCC, by treatment type and AEs observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Included were adult commercial and Medicare Advantage enrollees with \u22652 non\u2010diagnostic claims coded for HCC (the first setting the index date); \u22651 claim for systemic treatment of advanced\/metastatic HCC; and continuous enrollment for a 6\u2010month pre\u2010index baseline period to \u22651\u00a0month post\u2010index (follow\u2010up). Patients were excluded by lack of systemic treatment; incomplete demographic information; pregnancy, liver transplant, other cancers during baseline or clinical trial participation. We describe patient characteristics, common AEs, overall survival, and healthcare burden in 2017 USD up to 12\u2009months after initiation of tyrosine kinase inhibitor (TKI) monotherapy; immune checkpoint inhibitor (ICI) monotherapy; or FOLFOX combination therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analytic sample consisted of 322 patients (median age 65.8\u2009years, 76% male) who had 12\u2009months' (unless death occurred prior) available follow\u2010up, with median follow\u2010up of 9\u00a0months. Among these, 241 (75%) had TKI monotherapy, 23 (7%) had ICI monotherapy, and 58 had FOLFOX (18%) first\u2010line treatment. Overall, patients had a high burden of AEs (mean 3.2), with the most prevalent being pain (75%), infection (39%), ascites (34%), and bleeding (29%). After adjusting for covariates, infection ($50\u2009374), fever ($47\u2009443), and diarrhea ($29\u2009912) imposed the highest incremental annual costs versus patients without the AE. Up to 90% of costs were attributable to inpatient admissions, with 56% to 60% involving intensive care. Median 1\u2010year survival was 32%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This real\u2010world study demonstrated AE burden in alignment with previous clinical studies. Regardless of regimen used, AEs are associated with substantial healthcare costs due to inpatient care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.1504","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T02:43:02Z","timestamp":1631068982000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Healthcare costs related to adverse events in hepatocellular carcinoma treatment: A retrospective observational claims study"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9123-2434","authenticated-orcid":false,"given":"Lincy S.","family":"Lal","sequence":"first","affiliation":[{"name":"Health Economics and Outcomes Research Optum  Eden Prairie Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdalla","family":"Aly","sequence":"additional","affiliation":[{"name":"US Medical Affairs AstraZeneca  Gaithersburg Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa B.","family":"Le","sequence":"additional","affiliation":[{"name":"Health Economics and Outcomes Research Optum  Eden Prairie Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Peckous","sequence":"additional","affiliation":[{"name":"Health Economics and Outcomes Research Optum  Eden Prairie Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Seal","sequence":"additional","affiliation":[{"name":"US Medical Affairs AstraZeneca  Gaithersburg Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"April","family":"Teitelbaum","sequence":"additional","affiliation":[{"name":"Hematology Oncology Associates  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,9,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.09.016"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2217\/hep-2020-0024"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.64.7412"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21590"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002889"},{"key":"e_1_2_11_8_1","unstructured":"National Comprehensive Cancer Network.2020.Clinical practice guidelines in oncology; NCCN guidelines\u00ae for hepatobiliary cancers V1.2020. National Comprehensive Cancer Network Inc. 2020.https:\/\/www.nccn.org\/store\/login\/login.aspx?ReturnURL=https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/hepatobiliary.pdf."},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.03.019"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdy308"},{"key":"e_1_2_11_11_1","unstructured":"National Comprehensive Cancer Network.2019.Clinical practice guidelines in oncology; NCCN guidelines\u00ae for hepatobiliary cancers V1.2019. National Comprehensive Cancer Network Inc. 2019.https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/hepatobiliary.pdf."},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12450"},{"key":"e_1_2_11_13_1","unstructured":"SEER 18.2010\u20102016 5\u2010year relative survival. 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