(020) Incremental Burden of Comorbidity on Health-Related Quality of Life in Patients with Prostate Cancer

Background: Prostate cancer (PrC) is the second most diagnosed cancer in men with approximately 1.4 million cases worldwide in 2020, with 59% prevalence in those > 79 years. Prostate cancer, if diagnosed early, has a survival rate > 90%. However, patients may face deterioration of health-related quality of life (HRQOL) due to treatment-related adverse effects and disease severity confounded by comorbidities.

Objectives: The primary aim of the study is to quantify the impact of the incremental burden of comorbidities on the HRQOL of PrC patients. We also seek to better understand HRQOL and its relationship with patient demographics, and healthcare resource utilization (HCRU).

Methods: A retrospective study using Inspire Integrated Analytical Database, which links Inspire patient voice with medical and pharmacy claims. Inspire members who completed the EQ-5D-5L (EQ5D) questionnaire as a convenience sample and had at least one medical claim with an ICD-10 code for prostate cancer from 01/01/2015 to 12/31/2022 were included. EQ5D utility index was generated using the US value set. Comorbidities in claims data were used to generate the Charlson comorbidity index (CCI). Baseline patient characteristics, EQ5D, and HCRU were described. Bivariate analysis between CCI categories and EQ5D scores was conducted to determine the association.

Results: A total of 118 PrC patients were identified, with a median follow-up time of 65 months from the index date. The median age at diagnosis was 73 and 95% of patients were White or Caucasian. The mean number of pre-existing comorbidities was 0.51. The most common comorbid condition was diabetes (13%). Median EQ5D visual analog scale (VAS) and utility index were 78 and 0.90, respectively. When comparing patients with CCI 3 and CCI = 0, there was a 27% reduction in median EQ5D utility index although not statistically significant (0.68 & 0.93). However, PrC patients with diabetes have significantly lower utility index than PrC patients with no comorbidities. Prior to index date, searches on the Inspire platform included “erectile dysfunction advice”, “sbrt”, “tulsa-pro” and “lupron”. Searches after the index date included additional treatment types such as “adt”, “brachytherapy”, “focal laser ablation” and “orgovyx”.

Conclusions: Integrating HRQOL with claims data may provide unique insights into the cancer journey. Worse quality of life is associated with the higher comorbidity burden among patients with prostate cancer. A longitudinal study is warranted to better understand the impact of treatment and comorbidities on HRQOL.