Patients with epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) positive advanced non-small cell lung cancer (NSCLC) acquire excellent clinical outcomes from oral tyrosine kinase inhibitors (TKIs) compared with other systemic therapies.

The research investigated the association of out-of-pocket (OOP) costs for tyrosine kinase inhibitors (TKIs) with overall survival (OS) in epidermal growth factor receptor (EGFR)- and anaplastic lymphoma kinase (ALK)-positive advanced non–small-cell lung cancer (NSCLC). Further, the research focused on TKI OOP costs with TKI adherence, duration of therapy (DOT), and TKI discontinuation.

The study involved data collected from a list of 105 eligible patients with TKI claims from the Hutchinson Institute for Cancer Outcomes Research database. According to the study a landmark was created based on the average monthly TKI OOP costs per patient up to 3 months from TKI initiation, categorizing patients into quartiles of TKI OOP costs.

The median average monthly TKI out-of-pocket costs in Q1-3 was $1,431 for 78 patients and $2,888 for 27 patients in Q4. The median duration of TKI therapy was 6.0 months vs. 7.0 months. Within 3 months of TKI initiation, 10.3% vs 48.2% discontinued TKI therapy.

The conclusion is that among patients with advanced EGFR- and ALK-positive NSCLC, higher TKI OOP costs are associated with decreased TKI adherence associated with a higher likelihood of TKI discontinuation, and inferior survival.