Healthcare resource utilization and associated cost of patients with bone metastases from solid tumors who are naïve to bone-targeting agents: a comparative analysis of patients with and without skeletal-related events

Abstract

Background This study analyzes the impact of skeletal-related events (SRE) on healthcare resource utilization (HCRU) and costs incurred by patients with bone metastases (BM) from solid tumors (ST), who are therapy-naïve to bone targeting agents (BTAs). Methods German claims data from 01/01/2010 to 30/06/2018 were used to conduct a retrospective comparative cohort analysis of BTA-naive patients with a BM diagnosis and preceding ST diagnosis. HCRU and treatment-related costs were compared in two matched cohorts of patients with and without a history of SREs, defined as pathological fracture, spinal cord compression, surgery to bone and radiation to bone. The first SRE was defined as the patient-individual index date. Conversely, for the non-SRE patients, index dates were assigned randomly. Results In total, 45.20% of 9,832 patients reported experiencing at least one SRE (n = 4444) while 54.80% experienced none (n = 5388); 2,434 pairs of SRE and non-SRE patients were finally matched (mean age: 70.87/71.07 years; females: 39.07%/38.58%). Between SRE and non-SRE cohorts, significant differences in the average number of hospitalization days per patient-year (35.80/30.80) and associated inpatient-care costs (14,199.27€/10,787.31€) were observed. The total cost ratio was 1.16 (p < 0.001) with an average cost breakdown of 23,689.54€ and 20,403.27€ per patient-year in SRE and non-SRE patients. Conclusion The underutilization of BTAs within a clinical setting poses an ongoing challenge in the real-world treatment of BM patients throughout Germany. Ultimately, the economic burden of treating SREs in patients with BM from ST was found to be considerable, resulting in higher direct healthcare costs and increased utilization of inpatient care facilities.

Healthcare Resource Utilization and Cost of Patients with Multiple Myeloma in Germany: A Retrospective Claims Data Analysis

“…Finally, this study used a regional claims dataset from AOK PLUS, and, therefore, the applicability of the results to the whole of Germany could be limited. However, several previous retrospective studies [32,33] using AOK PLUS claims data confirmed that although patient characteristics may not exactly reflect the country average, the uniform treatment rules observed throughout the country make the AOK PLUS database useful for understanding the economic burden of diseases with a high level of generalizability.…”

Early economic modeling of magnetic resonance image-guided high intensity focused ultrasound compared to radiotherapy for pain palliation of bone metastases

“…Published cost-of-illness studies and surveys indicate that the proportion of out-patient treatments in Germany is 50-60% (15,16,23,27) with no significant difference between German general hospitals, practices, and university hospitals (15). However, these studies assessed bone metastases in general (including complicated bone metastases, patients receiving post-operative radiation for spinal metastases, sometimes with pronounced neurological symptoms), while our patient population (uncomplicated bone metastases) is less likely to require in-patient treatment.…”

“…Costs associated with a pathological fracture were extracted from a retrospective cost-of-illness study based on German claims data including 2434 patients with bone metastases and solid tumours (23). These costs included in-and out-patient consultations, rehabilitation, out-patient prescriptions, aids, and remedies (23). Costs were adjusted for inflation to the target year 2021 based on the harmonized index of consumer price (32).…”

Improving Bone Health in Patients with Metastatic Prostate Cancer with the Use of Algorithm-Based Clinical Practice Tool

“…Moreover, patients with PCa are at a high risk of bone-related complications such as pathological fracture, painful bone lesions requiring surgery or radiation, or spinal cord compression, collectively referred to as skeletal-related events [SREs] [ 15 ]. SREs are sentinel events that cause pain, impair quality of life, function, and survival, and increase healthcare utilization [ 16 , 17 ].…”