PHS32 - Incremental Healthcare Resource use and Costs Associated with Skeletal-Related Events in Patients with Bone Metastases from Solid Tumors

Abstract

Skeletal-Related Events (SREs) are common in patients with bone metastases (BM) from solid tumors (ST). Guidelines recommend prophylactic therapy for SRE prevention. SREs are associated with poor survival and high costs. The objective was to estimate the additional economic burden of SREs, measured by healthcare resource use (HRU) and costs, in patients with BM from ST. In this retrospective database analysis, adults with ≥1 inpatient or ≥2 outpatient ST diagnosis followed by ≥1 diagnosis of BM between 01/01/2011 and 06/30/2016 were identified from IQVIA’s PharMetrics Plus healthplan claims database. All patients had continuous enrollment for ≥12 months pre-BM date and ≥6 months post-BM date. First SRE date on or after first BM diagnosis was the index date. Patients with SRE(s) were propensity score matched 1:1 to patients without SREs (controls) using pre-index demographic and clinical characteristics, and costs. Patients were followed until the earlier of last enrollment date or 12/31/2016. Per-patient-per-year (PPPY) HRU and costs were measured during follow-up. McNemar’s and Wilcoxon signed-rank tests were conducted to assess HRU and cost differences. A total of 7,030 patients with SREs and 7,030 matched controls were included in the analysis (mean age: 59 years; female: 55%; mean follow up: 19.6 months; prophylactic therapy: 23.6%). Compared to controls, SRE patients had higher proportion and frequency of hospitalizations (70.9% vs. 48.5%; and 2.6 vs. 1.5, respectively) and emergency room visits (59.5% vs. 46.9%; and 1.7 vs. 1.2, respectively), as-well-as higher costs PPPY ($186,620 vs. $121,281); p<0.0001 for all comparisons. Primary cost attributes were hospitalizations and ancillary costs, with additional PPPY costs of $25,370 and $28,573, respectively, for patients with SREs. Higher economic burden was observed in patients with SREs vs. no SREs (1.7 additional hospitalizations and $65,000 additional cost PPPY). Given its high economic burden, management of SREs with prophylactic therapy is important.