Abstract
BackgroundBone complications, also known as skeletal-related events (SREs), are common in patients with bone metastases secondary to advanced cancers.ObjectiveTo provide a detailed estimate of the health resource utilization (HRU) burden associated with SREs across eight European countries.MethodsEligible patients from centers in Austria, the Czech Republic, Finland, Greece, Poland, Portugal, Sweden, and Switzerland with bone metastases or lesions secondary to breast cancer, prostate, or lung cancer or multiple myeloma who had experienced at least one SRE (defined as radiation to bone, long-bone pathologic fracture, other bone pathologic fracture, surgery to bone or spinal cord compression) were entered into this study. HRU data were extracted retrospectively from the patients’ charts from 3.5 months before the index SRE until 3 months after the index SRE (defined as an SRE preceded by an SRE-free period of at least 6.5 months).ResultsOverall, the mean number of inpatient stays per SRE increased from baseline by approximately 0.5–1.5 stays, with increases in the total duration of inpatient stays of approximately 6–37 days per event. All SREs were associated with substantial increases from baseline in the frequency of procedures and the number of outpatient and day-care visits.ConclusionsSREs are associated with substantial HRU owing to considerable increases in the number and duration of inpatient stays, and in the number of procedures, outpatient visits, and day-care visits. These data collectively provide a valuable summary of the real-world SRE burden on European healthcare systems.
Highlights
The progression of cancer to the skeleton is a common occurrence in patients with advanced disease; at postmortem examination, 65–90 % of patients with breast or prostate cancer and approximately 35 % of individuals with lung cancer have bone metastases [1, 2] and almost all patients with multiple myeloma develop bone lesions [3]
Differences were seen in the proportions of patients with each primary tumor type across the countries: fewer enrolled patients had breast cancer in Sweden (5.0 %) than in Austria (52.7 %) or the Czech Republic (53.1 %); fewer enrolled patients in Sweden (3.4 %) and the Czech Republic (5.4 %) had lung cancer than in the other countries; and a smaller proportion of patients in Austria (4.6 %) and Greece (9.9 %) had prostate cancer than in Sweden (49.6 %)
All skeletalrelated events (SREs) were associated with substantial health resource utilization (HRU), demonstrated by increases from baseline in the number and duration of inpatient stays, as well as in the number of procedures and outpatient, emergency room, and day-care visits
Summary
The progression of cancer to the skeleton is a common occurrence in patients with advanced disease; at postmortem examination, 65–90 % of patients with breast or prostate cancer and approximately 35 % of individuals with lung cancer have bone metastases [1, 2] and almost all patients with multiple myeloma develop bone lesions [3]. Metastatic bone disease is the cause of considerable morbidity [2], with affected patients at high risk of experiencing bone complications, referred to as skeletalrelated events (SREs), including radiation to bone, pathologic fracture, surgery to bone, and spinal cord compression [4]. A retrospective analysis from the Netherlands estimated that the mean per patient cost to treat SREs in individuals with prostate cancer and bone metastases was €6973 (range, €1187–€40,948) [11]. Despite the differences in the healthcare systems in the Netherlands and the UK, similar values have been reported for patients in the UK with breast cancer and bone metastases, with an estimated mean lifetime SRE-associated cost of £11,314–£19,121 (€14,029–€23,710; 1 GBP = 1.24 EUR) [12]. Known as skeletalrelated events (SREs), are common in patients with bone metastases secondary to advanced cancers
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