Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep;4(3):439-447.
doi: 10.1007/s41669-019-00185-8.

A Retrospective Claims Analysis of Advanced Prostate Cancer Costs and Resource Use

Sreevalsa Appukkuttan  1 , Krishna Tangirala  2 , Svetlana Babajanyan  2 , Lonnie Wen  2 , Stacey Simmons  2 , Neal Shore  3
Affiliations

A Retrospective Claims Analysis of Advanced Prostate Cancer Costs and Resource Use

Sreevalsa Appukkuttan et al. Pharmacoecon Open. 2020 Sep.

Abstract

Background: Castration-resistant prostate cancer (CRPC) is associated with high costs and healthcare resource utilization (HCRU).

Objective: This study followed patients with CRPC through their continuum of care and analyzed claims data regarding treatments, total HCRU, and costs, both before and after metastasis diagnosis.

Methods: A retrospective cohort of patients with newly diagnosed metastatic CRPC (mCRPC) in the USA was identified from the Truven Health MarketScan database from January 2009 to March 2015. The mCRPC algorithm employed International Classification of Diseases, Ninth Revision codes for prostate cancer (pre-index) and secondary metastatic disease (index date) and a subsequent claim for a US FDA-approved treatment for mCRPC. Patient inclusion required evidence of surgical or pharmacological castration and no evidence of bone-targeted treatments during the baseline period while evaluating continuous enrollment 25 months pre-index and 6 months post-index. Treatment patterns were assessed during pre- and post-index periods; HCRU and costs were annualized for comparison purposes regarding both pre- and post-index timeframes.

Results: Among 261 patients with mCRPC (mean age 72 years), the most common treatments during the pre-index period were bicalutamide (90.04%), leuprolide (81.99%), abiraterone (22.22%), docetaxel (20.69%), and ketoconazole (18.01%). Mean per-patient-per-year (PPPY) all-cause annualized healthcare costs significantly increased from $US35,102.55 in the pre-index nonmetastatic CRPC (nmCRPC) period to $US156,499.89 after metastasis diagnosis (mCRPC). Mean PPPY inpatient admissions and emergency department visits increased from 0.20 to 1.36 and from 0.63 to 1.56, respectively.

Conclusions: Average yearly costs and HCRU were four times higher following mCRPC diagnosis, indicating a need for appropriate management strategies to optimize the potential delay of disease progression among patients with nmCRPC.

PubMed Disclaimer

Conflict of interest statement

SA, SB, LW, and SS are employees of Bayer HealthCare Pharmaceuticals. KT was an employee of Bayer HealthCare Pharmaceuticals at the time the study was conducted. NS is an employee of Carolina Urologic Research Institute and served as a paid consultant to Bayer.

Figures

Fig. 1
Fig. 1
Study design. HCRU healthcare resource utilization
Fig. 2
Fig. 2
CONSORT diagram
Fig. 3
Fig. 3
Frequency of treatment utilization. mCRPC metastatic castration-resistant prostate cancer, nmCRPC nonmetastatic castration-resistant prostate cancer
Fig. 4
Fig. 4
Total monthly healthcare costs per patient. mCRPC metastatic castration-resistant prostate cancer, nmCRPC nonmetastatic castration-resistant prostate cancer, Rx prescription claims
See this image and copyright information in PMC

References

    1. National Cancer Institute. Cancer stat facts: prostate cancer. https://seer.cancer.gov/statfacts/html/prost.html. Accessed 26 Apr 2018.
    1. Velcheti V, Kamik S, Bardot S, Prakash O. Pathogenesis of prostate cancer: lessons from basic research. Oschner J. 2008;8:213–218. - PMC - PubMed
    1. Kirby M, Hirst C, Crawford ED. Characterising the castration-resistant prostate cancer population: a systematic review. Int J Clin Pract. 2011;65(11):1180–1192. doi: 10.1111/j.1742-1241.2011.02799.x. - DOI - PubMed
    1. Smith MR, Saad F, Chowdhury S, et al. Apalutamide treatment and metastasis-free survival in prostate cancer. N Engl J Med. 2018;378(15):1408–1418. doi: 10.1056/NEJMoa1715546. - DOI - PubMed
    1. Steinburn CN, Fizazi K, Saad F, et al. Prostate specific antigen response in men with nmCRPC (M0 CRPC) treated with enzalutamide. Results from PROSPER. Presented at the European Association of Urology; March 16–20, 2018, Copenhagen.

LinkOut - more resources