Healthcare Resource Utilization and Costs of Adverse Events Among Patients with Metastatic Urothelial Cancer in USA

Abstract

Aim: To estimate incremental costs and healthcare resource utilization (HRU) associated with select severe adverse events (AEs) and AEs of any severity in patients with metastatic urothelial carcinoma receiving first-line (1L) therapy. Materials & methods: Adults treated with 1L systemic therapy between January 2012 and September 2017 with ≥1 urothelial cancer diagnosis were identified using claims data. Per-patient-per-month cost differences and HRU rate ratios comparing patients with and without select AEs were estimated. Results: Patients with any severe select AEs had higher costs than those without (cost difference = $6130 per-patient-per-month; p 0.001). Healthcare costs and HRU for patients with select AEs were significantly higher versus those without. Conclusion: Select AEs during 1L therapy for metastatic urothelial carcinoma can result in significant burden to patients and healthcare systems.

Keywords::

• bladder cancer
• chemotherapy toxicity
• health care costs
• immunotherapy-related adverse events
• urologic carcinoma

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/fon-2019-0434

Previous presentation

Part of the material in this manuscript was previously presented at the ICPE Annual Conference 2019, ASCO Genitourinary Cancers Symposium 2019, and AMCP Nexus 2018

Acknowledgments

The authors would like to thank D Lejeune, C O’Connor and P Jacques for their assistance with statistical analyses.

Financial & competing interests disclosure

This research was funded by AstraZeneca US. R Shenolikar and Y Doleh are employees and stockholders of AstraZeneca. M Duh, M DerSarkissian and F Laliberté report grants from AstraZeneca, during the conduct of the study; grants from numerous pharmaceutical manufacturers, including Pfizer, GSK, Janssen, Bayer, Ipsen, Takeda, Sanofi, Shire, Kiniksa, Novo Nordisk, TARIS, Eisai, Allergan, Merck and Medtronic outside the submitted work. P Grivas has received research funding and has provided consulting to AstraZeneca. P Grivas reports personal fees and other from AstraZeneca, during the conduct of the study; personal fees and other from Genentech, personal fees from Dendreon, personal fees and other from Bayer, personal fees and other from Merck & Co., personal fees and other from Mirati, other from Oncogenex, personal fees and other from Pfizer, personal fees and other from Bristol-Myers Squibb, personal fees from Exelixis, personal fees from Biocept, personal fees and other from ClovisOncology, personal fees from EMD Serono, personal fees from Seattle Genetics, personal fees from Foundation Medicine, personal fees from Driver Inc., personal fees from QED Therapeutics, personal fees from Heron Therapeutics, personal fees from Janssen, other from Bavarian Nordic, other from Immunomedics, other from Debiopharm, outside the submitted work. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

This research was funded by AstraZeneca US. R Shenolikar and Y Doleh are employees and stockholders of AstraZeneca. M Duh, M DerSarkissian and F Laliberté report grants from AstraZeneca, during the conduct of the study; grants from numerous pharmaceutical manufacturers, including Pfizer, GSK, Janssen, Bayer, Ipsen, Takeda, Sanofi, Shire, Kiniksa, Novo Nordisk, TARIS, Eisai, Allergan, Merck and Medtronic outside the submitted work. P Grivas has received research funding and has provided consulting to AstraZeneca. P Grivas reports personal fees and other from AstraZeneca, during the conduct of the study; personal fees and other from Genentech, personal fees from Dendreon, personal fees and other from Bayer, personal fees and other from Merck & Co., personal fees and other from Mirati, other from Oncogenex, personal fees and other from Pfizer, personal fees and other from Bristol-Myers Squibb, personal fees from Exelixis, personal fees from Biocept, personal fees and other from ClovisOncology, personal fees from EMD Serono, personal fees from Seattle Genetics, personal fees from Foundation Medicine, personal fees from Driver Inc., personal fees from QED Therapeutics, personal fees from Heron Therapeutics, personal fees from Janssen, other from Bavarian Nordic, other from Immunomedics, other from Debiopharm, outside the submitted work. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.