SUO 2017: Healthcare Resource Utilization, Costs And Treatments In A US Population Of Non-metastatic And Metastatic Castration Resistant Prostate Cancer

Washington, DC (UroToday.com) Introduction: Health care resource use (HCRU) and costs among non-metastatic castration resistant prostate cancer (nmCRPC) patients who develop metastases have not been quantified among the insured US population. Previous studies have followed prostate cancer (PC) patients before and after metastasis diagnosis but have not focused on CRPC patients. The authors in this study follow nmCRPC patients through their continuum of care and describe the treatments, costs, and total HCRU during the year before and after metastasis diagnosis.

Methods: This was a retrospective study of metastatic CRPC (mCRPC) patients from the MarketScan database from January 2009 to March 2015 with metastasis diagnosis as the index date. mCRPC algorithm was based on ICD-9 codes for both PC and secondary metastasis disease (including lymph, viscera and bone mets), and a subsequent claim for an FDA approved treatment for mCRPC. Patients were also required to have evidence of surgical or medical castration with no evidence of bone antineoplastic treatments at baseline. Costs and HCRU were compared in the 1 year pre- and post-index time periods.

Results: Among the 261 patients identified (mean age=72.1, 71% were ≥65 years), 79.3% had bone metastases. Most common treatments in the nmCRPC stage were bicalutamide (90%), leuprolide (82%), abiraterone (22.2%) docetaxel (20.7%), and ketoconazole (18%). Mean per patient per year (PPPY) inpatient visits (0.2 vs. 1.4), office visits (11.7 vs. 21.1) and ER visits (0.6 vs 2.4) were higher post metastasis compared to the nmCRPC period. Total costs were also higher during the metastasis stage compared to nmCRPC.

Conclusion: Average yearly HCRU and costs more than doubled following the mCRPC diagnosis, which indicates the need for appropriate management strategies for nmCRPC patients, in order to optimize the potential delay of disease progression.

Presented by: Neal D. Shore, Carolina Urologic Research Center, Atlantic Urology Clinics, USA

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, @GoldbergHanan, at the 18th Annual Meeting of the Society of Urologic Oncology, November 29-December 1, 2017 – Washington, DC
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