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J Med Econ ; 16(5): 691-700, 2013.
Article in English | MEDLINE | ID: mdl-23441975

ABSTRACT

OBJECTIVES: Patients with bone metastases often experience skeletal-related events (SREs: radiation or surgery to bone, pathologic fracture, and spinal cord compression). This study examined health resource utilization and costs associated with SREs. METHODS: Data presented are from the European cohort (Germany, Italy, Spain, and the UK) of patients with solid tumours enrolled in a multi-national, prospective, observational study in patients with solid tumours or multiple myeloma. Patients with Eastern Cooperative Oncology Group score 0-2 and life expectancy ≥6 months, who experienced an SRE up to 97 days before enrolment, were eligible. Health resource utilization associated with SREs (including number/length of inpatient stays, numbers of procedures and outpatient visits) were collected through chart review for up to 97 days before enrolment and prospectively during follow-up. Country-specific cost calculations were performed. RESULTS: In total, 478 eligible patients contributed 893 SREs to this analysis. Radiation to bone occurred most frequently (66% of total). Spinal cord compression (7%) and surgery to bone (10%) were the least common events, but most likely to require inpatient stays. The most costly SREs were also spinal cord compression (mean per SRE across countries, €4884-€12,082) and surgery to bone (€3348-€9407). Inpatient stays were the main cost drivers. LIMITATIONS: Health resource utilization used to calculate the costs associated with SREs may have been under-estimated as a result of exclusion of patients with low performance status or life expectancy; unavailable information and exclusion of resource consumption associated with pain. Thus, the estimate of associated costs is likely to be conservative. CONCLUSIONS: SREs result in considerable health resource utilization, imposing a substantial financial burden driven by inpatient stays. Treatments that prevent/delay SREs may help ease this burden, thereby providing cost savings across European healthcare systems.


Subject(s)
Bone Neoplasms/economics , Bone Neoplasms/metabolism , Wounds and Injuries/economics , Wounds and Injuries/etiology , Costs and Cost Analysis , Europe/epidemiology , Fractures, Bone/economics , Fractures, Bone/etiology , Health Services/economics , Health Services/statistics & numerical data , Humans , Length of Stay/economics , Length of Stay/statistics & numerical data , Multicenter Studies as Topic , Neoplasm Metastasis , Orthopedic Procedures/economics , Osteoradionecrosis/economics , Prospective Studies , Spinal Cord Compression/economics , Spinal Cord Compression/etiology
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