Health resource utilization associated with skeletal-related events in patients with bone metastases: Results from a multinational retrospective - prospective observational study - a cohort from 4 European countries

Abstract

Background: Skeletal-related events (SREs; pathologic fracture, radiation or surgery to bone, spinal cord compression) frequently occur in patients with advanced cancer with bone metastases/lesions. Limited data on the associated patient and economic burden are available to aid in resource planning and evaluating treatment options.

Methods: Patients with bone metastases/lesions secondary to breast, lung or prostate cancer or multiple myeloma; with at least one SRE within 97 days prior to enrollment; life expectancy of at least 6 months; and Eastern Cooperative Oncology Group performance status 0, 1 or 2 were recruited. Information on health resource utilization (HRU; including number/duration of hospitalizations, outpatient visits, procedures), attributed by investigators to be associated with a SRE, was collected retrospectively for up to 97 days prior to enrollment and prospectively for up to 18-21 months.

Results: A total of 631 patients contributing 1282 SREs, were enrolled across Germany, Italy, Spain and the United Kingdom. Approximately a third of all SREs required an inpatient stay. Mean duration of inpatient stay for patients with SREs requiring one ranged from 8.4 to 41.1 days across all countries and SRE types.

Conclusion: All types of SREs are associated with substantial HRU burden. Preventing SREs by using the best therapeutic options available may help to reduce the burden to patients and healthcare systems.

Keywords: Advanced cancer; Bone metastases; ECOG, Eastern Cooperative Oncology Group; HRU, health resource utilization; Health resource utilization; Observational research; SRE, skeletal-related event; Skeletal-related event.

Fig. 1

(A) Mean+SD number of inpatient stays per SRE and (B) mean+SD length of hospital stays per SRE (excluding SREs without a stay), by country and SRE type. PF, pathologic fracture; RB, radiation to bone; SB, surgery to bone; SCC, spinal cord compression; SD, standard deviation; and SRE, skeletal-related event.

Fig. 2

(A) Mean+SD number of outpatient visits per SRE and (B) mean+SD number of procedures performed per SRE, by country and SRE type. (B) Includes both outpatient and procedures (i.e. imaging, surgery, etc.). Radiation procedures with multiple sessions were captured as multiple procedures. PF, pathologic fracture; RB, radiation to bone; SB, surgery to bone; SCC, spinal cord compression; SD, standard deviation; and SRE, skeletal-related event.