(294) Healthcare Resource Utilization and Costs Among Patients With vs Without Biomarker Testing in Metastatic Colorectal Cancer (mCRC): A Real-World Analysis of Horizon BCBSNJ Members

Background: : Colorectal cancer remains the second leading cause of cancer-related death in the United States.2 The treatment landscape for metastatic colorectal cancer (mCRC) has evolved with the availability of biomarker-driven therapies that can improve clinical outcomes through precision medicine. NCCN guidelines recommend testing for key biomarkers, including BRAF V600E, MSI/MMR, KRAS/NRAS, and HER2+, to guide therapy selection at the time of diagnosis or treatment initiation.2 Biomarker results inform eligibility for targeted treatments (ex: EGFR inhibitors, immunotherapy, BRAF/MEK inhibitors), which may lead to better disease control, fewer adverse events, and cost-effective care.3 Despite strong guideline support, real-world adherence to biomarker testing remains suboptimal, with prior research showing variability by payer type, provider practice, and patient demographics.5-6 Causes for this underuse include lack of insurance coverage, prolonged test turnaround time, insufficient tissue samples, and limited infrastructure for reflex testing in non-academic settings.1 Patients who do not receive timely testing may initiate therapy with agents that are less effective or inappropriate based on tumor biology, leading to avoidable costs and poorer outcomes.4 Understanding the real-world healthcare resource utilization (HCRU) and total cost of care (TCOC) associated with biomarker testing can help inform payer strategies to improve adherence and ensure patients receive appropriate guideline-directed therapy.

Objective: : To understand the utilization of biomarker testing and evaluate all-cause healthcare resource utilization and total cost of care among patients with metastatic colorectal cancer (mCRC), stratified by biomarker testing (tested vs. not tested).

Methods: : Commercial adults > 18 years old with metastatic colorectal cancer (mCRC) who initiated systemic therapy and were enrolled in Horizon BCBSNJ during the study period with a continuous commercial enrollment in medical and pharmacy benefits for at least 6 months prior to index date and 6 months after the index date.

Results: : TBD

Conclusions: : TBD

Sponsorship:: This study does not require external funding