Healthcare resource use in advanced prostate cancer patients treated with docetaxel

Abstract

Objective:

Although the treatment of metastatic castrate-resistant prostate cancer (mCRPC) has improved with newer therapies, there is little understanding how these therapies have impacted resource use and associated expenditures; available estimates are dated. The current study examined contemporary healthcare utilization and associated costs for mCRPC patients and how these measures changed over time.

Methods:

This retrospective cohort analysis used medical and pharmaceutical insurance claims data from a large non-payer-owned integrated claims database of US commercial insurers. Amongst all patients with a prostate cancer diagnosis (n = 256,464), those with ≥ 1 docetaxel claim (docetaxel cohort, n = 3642) were identified as mCRPC patients. Within the docetaxel cohort, an additional 6-months follow-up cohort (n = 2862) was identified, i.e., patients with at least 6 months of follow-up after the first docetaxel claim. Resource utilization and costs were identified for all-cause hospitalizations, emergency room (ER) visits, physician visits and ambulatory visits, and prostate cancer-related prescription treatments.

Results:

Significant increases in the mean per-patient-per-month (PPPM) count for the docetaxel cohort were observed for all medical resources measured (hospitalizations and ER, physician, and ambulatory visits) in the post-docetaxel period compared with the pre-docetaxel period (p < 0.0001); similar significant increases were observed for the 6-months follow-up cohort in the last 6 months (prior to lost to follow-up date) compared with the period preceding the last 6 months (p < 0.0408 ambulatory visits, p < 0.0001 all other resources). Total docetaxel cohort costs (mean [standard deviation]) rose from an average PPPM cost of US$2593 (3208) in the pre-docetaxel period to US$5847 (6990) in the post-docetaxel period (p < 0.0001); each of the individual resources measured (hospitalization, all healthcare visits, and prescription costs) demonstrated significant increases (p < 0.0001).

Limitations:

Retrospective study design.

Conclusions:

This large database analysis showed a significant increase in use of healthcare resources and associated costs among mCRPC patients following first-line docetaxel treatment.

Keywords::

• Metastatic castrate-resistant prostate cancer
• Chemotherapy
• Health outcomes
• Health economics
• Cost
• Retrospective cohort study

Transparency

Declaration of funding

This study was funded by Janssen Global Services.

Declaration of financial/other relationships

Maneesha Mehra and Ravinder Dhawan are full-time employees of Janssen Global Services. Ying Wu was a full-time Janseen Global Services employee at the time the analysis was conducted and the manuscript was written.

Acknowledgments

This study was funded by Janssen Global Services. Writing assistance was provided by D. Wolf of PAREXEL, and was funded by Janssen Global Services.