Treatment, healthcare resource utilization, and costs associated with non-metastatic and metastatic castration-resistant prostate cancer: A claims analysis.

Abstract

e18341 Background: Limited evidence exists about economic burden in non-metastatic castrate resistant prostate cancer (nmCRPC). The aim of this study was to describe the real-world treatments in this setting and to quantify both the costs and healthcare resource utilization (HCRU) during the year before and after metastasis for this patient population. Methods: A retrospective cohort of metastatic castrate resistant prostate cancer (mCRPC) patients was identified from Truven Health MarketScan database from January 2009 to March 2015 with metastasis diagnosis as index date. mCRPC algorithm was based on ICD-9 codes for both prostate cancer and secondary metastatic disease, and a subsequent claim for a FDA approved treatment for mCRPC. Patients were also required to have evidence of surgical or medical castration in the baseline period to define nmCRPC. Costs and HCRU were compared in the 1 year pre- and post-index time periods. Results: Among 341 mCRPC patients identified, mean age was 71.9 years (72.4% ≥65 years old), 72.7% were Medicare Advantage patients and 19.4% had Klabunde comorbidity > 1. Most common treatments in the pre index period were bicalutamide (90%), leuprolide (83.6%), docetaxel (27.6%), abiraterone (22.9%) and ketoconazole (21.4%). Mean per patient per year (PPPY) all cause HCRU and costs were significantly higher (all P < 0.05) in the mCRPC patients compared to nmCRPC patients (Table). Conclusions: Average yearly costs more than doubled following mCRPC diagnosis, which indicates the need for appropriate management strategies for nmCRPC patients in order to optimize the potential delay of disease progression. [Table: see text]