Pd45-11 Temporal and Regional Patterns of Prostate Cancer Positron Emission Tomography Imaging Among Commercial Insurance Beneficiaries in the United States

You have accessJournal of UrologyProstate Cancer: Staging II (PD45) 1 May 2024PD45-11 TEMPORAL AND REGIONAL PATTERNS OF PROSTATE CANCER POSITRON EMISSION TOMOGRAPHY IMAGING AMONG COMMERCIAL INSURANCE BENEFICIARIES IN THE UNITED STATES Michael S. Leapman, Jessica B. Long, Sarah Westvold, Maximilian Rabil, Preston Sprenkle, Isaac Y. Kim, Lawrence Saperstein, Jaleh Fallah, Daniel Suzman, Catherine Lerro, Jianjin Xu, Paul G. Kluetz, R. Jeffrey Karnes, Natalia Kunst, Shi-Yi Wang, Xiaomei Ma, and Cary P. Gross Michael S. LeapmanMichael S. Leapman, Jessica B. LongJessica B. Long, Sarah WestvoldSarah Westvold, Maximilian RabilMaximilian Rabil, Preston SprenklePreston Sprenkle, Isaac Y. KimIsaac Y. Kim, Lawrence SapersteinLawrence Saperstein, Jaleh FallahJaleh Fallah, Daniel SuzmanDaniel Suzman, Catherine LerroCatherine Lerro, Jianjin XuJianjin Xu, Paul G. KluetzPaul G. Kluetz, R. Jeffrey KarnesR. Jeffrey Karnes, Natalia KunstNatalia Kunst, Shi-Yi WangShi-Yi Wang, Xiaomei MaXiaomei Ma, and Cary P. GrossCary P. Gross View All Author Informationhttps: //doi. org/10. 1097/01. JU. 0001008792. 09108. b4. 11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate specific membrane antigen positron emission tomography (PSMA-PET) imaging improves prostate cancer visualization and has been proposed as a tool to guide treatment decisions. As PSMA-PET imaging agents were not approved in the United States (US) until December 2020, little is known about national patterns of PET imaging utilization. METHODS: We conducted a dynamic cohort study to evaluate use of PET imaging among insurance beneficiaries aged 40-89 years with a diagnosis of prostate cancer using deidentified administrative claims from Blue Cross Blue Shield Axis. We calculated the proportions of patients undergoing PET imaging in semiannual periods from January 1, 2016, through December 31, 2022, examining tracers specific to prostate cancer, including PSMA-targeted agents as well as fluciclovine, sodium fluoride, and choline tracers. Cochran-Armitage tests were used to evaluate trends in the proportion of individuals receiving PET imaging over time. We also assessed the association between regional hospital referral region (HRR) level contextual sociodemographic and healthcare characteristics and regional use of PSMA-PET imaging in 2022 using chi-square tests. RESULTS: There were 410, 505 beneficiaries with prostate cancer identified in the study period. The semiannual proportion of patients undergoing PET imaging increased from 4. 5 (95% confidence interval (CI) 4. 1-5. 0 per 1, 000 in the first half of 2016 to 41. 7 (95% CI 40. 6-42. 9) per 1, 000 in the second half of 2022, p<0. 001. Increases in PET imaging were driven by uptake of PSMA-PET imaging, which increased from 0. 7 (95% CI 0. 6-0. 9) per 1000 in the second half of 2021 to 37. 5 (95% CI 36. 4-38. 6) per 1, 000 in the second half of 2022, p<0. 001. Following approvals of PSMA-PET agents, other forms of PET imaging rapidly decreased – from 18. 2 (95% CI 17. 4-18. 9) per 1000 in the second half of 2021 to 4. 6 (95% CI 4. 3-5. 0) per 1, 000 in the same period of 2022, p<0. 001. Compared to HRRs in quartile 1 (Q1), HRRs in Q4 of PSMA-PET use in 2022 had higher levels of education (25. 0% with college education or higher in Q1 versus 29. 4% in Q4, p=0. 005) and median household income (50, 200 in Q1 versus 60, 900 in Q4, p<0. 001). CONCLUSIONS: In this study from a large commercial US health insurer, PSMA-PET was rapidly incorporated into clinical practice and is now the dominant prostate cancer radiotracer. However, the initial uptake of PSMA-PET may be accompanied by disparity, as our data suggests less use in areas with lower income and education measures. Source of Funding: Food and Drug Administration (FDA) of the U. S. Department of Health and Human Services (HHS) as part of a financial assistance award FD005938. The contents are those of the author (s) and do not necessarily represent the official views of, nor an endorsement, by FDA/HHS, or the U. S. Government © 2024 by American Urological Association Education and Research, Inc. FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e972 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc. Metrics Author Information Michael S. Leapman More articles by this author Jessica B. Long More articles by this author Sarah Westvold More articles by this author Maximilian Rabil More articles by this author Preston Sprenkle More articles by this author Isaac Y. Kim More articles by this author Lawrence Saperstein More articles by this author Jaleh Fallah More articles by this author Daniel Suzman More articles by this author Catherine Lerro More articles by this author Jianjin Xu More articles by this author Paul G. Kluetz More articles by this author R. Jeffrey Karnes More articles by this author Natalia Kunst More articles by this author Shi-Yi Wang More articles by this author Xiaomei Ma More articles by this author Cary P. Gross More articles by this author Expand All Advertisement PDF downloadLoading. . .