Medical resource use and costs from subsequent metastases in patients with prostate cancer initially diagnosed with locoregional disease
In prostate cancer (PC), progression from locoregional to metastatic disease significantly impacts morbidity and mortality. We examined the impact of progression on medical resource use and healthcare costs.
Using the linked United States Surveillance, Epidemiology, and End Results and Medicare databases (2000-2012), we identified patients (pts) initially diagnosed with locoregional PC who progressed to metastatic disease ? 4 months after PC diagnosis (cases). Cases were matched up to a 1:4 ratio to controls (pts without metastases). Pts were evaluated 12 months before and for 12 months after metastases. Healthcare costs and medical resource use related to inpatient admissions, outpatient/emergency room (ER) visits, skeletal-related events (SRE), and chemotherapy were compared between cases and controls. Medicare claims were used to calculate average costs per month and resource use.
There were 10,370 cases and 39,200 controls. 85% of cases had bone metastases. For cases, total healthcare costs were similar to controls from 12 to 4 months before metastases. These costs rose sharply to $11,982 in the month of metastases diagnosis vs $1305 for controls, and stayed 3 times higher than costs for controls for the remainder of the observation period. Medical resource use followed the same pattern, as shown by incremental rates and costs among cases relative to controls (Table).
Progression to metastatic disease among PC pts initially diagnosed with locoregional disease significantly increased medical resource use and costs. Interventions to prevent or delay metastasis could result in decreased utilization of resources with associated cost reductions.
|Authors||Li, Shore N.; Mehra, M.; Todd, M.; Saadi. R.; Leblay, G.; Griffiths, R.; Aggarwal, J.|
|Service Area||Real-World Evidence|