The burden of skeletal-related events in four Latin American countries: Argentina, Brazil, Colombia, and Mexico

Figures & data

Table 1. Prevalence of solid tumors with bone metastasis.

	Argentina			Brazil			Colombia			Mexico
	Prostate cancer	Breast cancer	OSTs	Prostate cancer	Breast cancer	OSTs	Prostate cancer	Breast cancer	OSTs	Prostate cancer	Breast cancer	OSTs
Annual mortality^a (n)	4,938	6,778	58,859	19,712	18,818	188,625	3,743	3,385	35,112	7,556	7,776	73,223
Proportion with BM^1	70%	70%	35%	70%	70%	35%	70%	70%	35%	70%	70%	35%
Mortality with BM (n) (assumed equal to incidence of cancer with BM)	3,457	4,744	20,601	13,798	13,172	66,019	2,620	2,369	12,289	5,289	5,443	25,628
Survival (years)^41^,^42	2.24	3.73	1.73	2.24	3.73	1.73	2.24	3.73	1.73	2.24	3.73	1.73
Prevalence of cancer with BM (n) (incidence × survival)	7,743	17,697	35,639	30,908	49,133	114,212	5,869	8,838	21,260	11,848	20,302	44,337

Abbreviations. BM, bone metastasis; OST, other solid tumors.

^aEstimated mortality for 2020. Based on mortality rates⁴⁰ and population data from the World Bank Group (https://databank.worldbank.org).

Table 2. Prevalence of multiple myeloma with lytic bone lesions.

	Argentina	Brazil	Colombia	Mexico
(i) Ratio of MM prevalence in US to MM prevalence in LATAM country^a	28.8	5.4	23.6	18.05
(ii) Total prevalent cases in US in 2016^44	131,392	131,392	131,392	131,392
Total prevalent cases in LATAM country in 2016 (ii/i)	4,562	24,332	5,567	7,279
Estimated prevalence for LATAM country in 2020^b	4,754	25,124	5,910	7,623
Proportion with lytic bone lesions^46	86.4%	86.4%	86.4%	86.4%
Estimated prevalence of MM with lytic bone lesions (2020)	4,108	21,707	5,106	6,587

Abbreviations. LATAM, Latin-America; MM, multiple myeloma; US, United States.

^a5-year prevalence in US/5-year prevalence in the respective LATAM country (i.e. Argentina, Brazil, Colombia, or Mexico)⁴³.

^bBased on population growth (https://databank.worldbank.org).

Table 3. SRE management costs for Argentina, Brazil, Colombia, and Mexico.

SRE	Prostate cancer, breast cancer, and MM		Other solid tumors
	Argentinian Peso (ARS)	US Dollars (USD)^b	Argentinian Peso (ARS)	US Dollars (USD)^b
Argentina^a
Vertebral fracture	228,576	3,468	222,183	3,371
Non-vertebral fracture	209,528	3,179	200,696	3,045
Radiation to bone	352,684	5,351	346,291	5,254
Surgery to bone	387,024	5,872	370,810	5,626
Spinal cord compression	339,437	5,150	319,202	4,843
SRE	Brazilian Real (BRL)	US Dollars (USD)^d	Brazilian Real (BRL)	US Dollars (USD)^d
Brazil^c
Vertebral fracture	28,035	5,173	27,246	5,027
Non-vertebral fracture	18,811	3,471	18,022	3,325
Radiation to bone	43,538	8,033	42,749	7,887
Surgery to bone	18,811	3,471	18,022	3,325
Spinal cord compression	13,260	2,446	12,471	2,301
	All cancers
SRE	Colombian Peso (COP)		US Dollars (USD)^f
Colombia^e
Vertebral fracture	29,135,063		6,739
Non-vertebral fracture	22,738,106		5,259
Radiation to bone	10,991,298		2,542
Surgery to bone	29,135,063		6,739
Spinal cord compression	29,243,311		6,764
SRE	Mexican Peso (MXN)		US Dollars (USD)^h
Mexico^g
Vertebral fracture	78,813		2,971
Non-vertebral fracture	77,462		2,920
Radiation to bone	147,378		5,555
Surgery to bone	256,543		9,670
Spinal cord compression	484,638		18,268

Abbreviation. SRE, skeletal-related event.

^aCosts were informed by KOL feedback on medical resource utilization and costs from the Programa de Atención Médica Integral (Comprehensive Medical Care Program. PAMI. https://www.pami.org.ar/).

^bUSD-ARS exchange rate = 1:65.91³⁸.

^cCosts source: Tanaka et al.⁵⁴.

^dUSD-BRL exchange rate = 1:5.42³⁷.

^eCosts source: Pérez et al.⁵².

^fUSD-COP exchange rate = 1:4,323.39³⁷.

^gCosts were informed by data from the Instituto Mexicano del Seguro Social (Mexican Social Security Institute)^57,58.

^hUSD-MXN exchange rate = 1:26.53³⁷.

Table 4. One-year burden of illness of SRE in Argentina, Brazil, Colombia, and Mexico.

Cost category	1-year burden (Argentina)	1-year burden (Brazil)	1-year burden (Colombia)	1-year burden (Mexico)	1-year burden (total LATAM)
Vertebral fracture	$27,061,296	$140,855,041	$37,223,768	$31,318,732	$236,458,837
Non-vertebral fracture	$29,705,304	$109,433,597	$33,536,449	$36,363,098	$209,038,449
Radiation to bone	$94,995,836	$472,545,159	$29,389,300	$130,234,653	$727,164,949
Spinal cord compression	$10,608,735	$17,408,107	$9,749,707	$52,752,360	$90,518,909
Surgery to bone	$11,523,001	$23,140,439	$9,112,997	$25,565,502	$69,341,939
Productivity costs	$710,355	$15,702,107	$1,099,437	$5,571,418	$23,083,317
Total	$174,604,527	$779,084,451	$120,111,658	$281,805,763	$1,355,606,399

Abbreviations. LATAM, Latin America; SRE, skeletal-related event.

Table 5. One-year burden of illness of SRE in Argentina, Brazil, Colombia, and Mexico stratified by type of cancer.

Cost category	Argentina $ (%)	Brazil $ (%)	Colombia) $ (%)	Mexico $ (%)	Total LATAM $ (%)
Vertebral fracture	27,061,296 (100)	140,855,041 (100)	37,223,768 (100)	31,318,732 (100)	236,458,837 (100)
Prostate cancer	3,487,435 (13)	22,237,947 (16)	5,865,856 (16)	4,909,724 (16)	36,500,962 (15)
Breast cancer	7,783,294 (29)	32,709,078 (23)	8,005,311 (22)	7,852,960 (25)	56,350,643 (24)
Other ST	12,899,043 (48)	62,645,710 (44)	16,203,989 (44)	14,490,785 (46)	106,239,526 (45)
MM	2,891,524 (11)	23,262,307 (17)	7,148,612 (19)	4,065,263 (13)	37,367,707 (16)
Non-vertebral fracture	29,705,304 (100)	109,433,597 (100)	33,536,449 (100)	36,363,098 (100)	209,038,449 (100)
Prostate cancer	2,615,577 (9)	12,208,318 (11)	3,745,584 (11)	3,948,187 (11)	22,517,666 (11)
Breast cancer	9,852,661 (33)	30,308,073 (28)	8,627,704 (26)	10,658,668 (29)	59,447,106 (28)
Other ST	14,829,303 (50)	52,738,396 (48)	16,095,172 (48)	18,126,673 (50)	101,789,543 (49)
MM	2,407,764 (8)	14,178,810 (13)	5,067,990 (15)	3,629,570 (10)	25,284,133 (12)
Radiation to bone	94,995,836 (100)	472,545,159 (100)	29,389,300 (100)	130,234,653 (100)	727,164,949 (100)
Prostate cancer	14,092,302 (15)	84,304,254 (18)	5,265,210 (18)	22,687,237 (17)	126,349,003 (17)
Breast cancer	13,853,050 (15)	57,972,389 (12)	3,484,748 (12)	16,887,873 (13)	92,198,059 (13)
Other ST	66,260,108 (70)	323,530,105 (68)	20,148,090 (69)	89,274,784 (69)	499,213,087 (69)
MM	790,376 (1)	6,738,411 (1)	491,253 (2)	1,384,759 (1)	9,404,800 (1)
Spinal cord compression	10,608,735 (100)	17,408,107 (100)	9,749,707 (100)	52,752,360 (100)	90,518,909 (100)
Prostate cancer	2,046,114 (19)	4,141,139 (24)	2,337,689 (24)	11,939,081 (23)	20,464,024
Breast cancer	866,085 (8)	1,198,435 (7)	601,497 (6)	3,653,352 (7)	6,319,369
Other ST	7,627,651 (72)	11,885,569 (68)	6,693,165 (69)	36,751,065 (70)	62,957,450
MM	68,884 (1)	182,964 (1)	117,355 (1)	408,863 (1)	778,066
Surgery to bone	11,523,001 (100)	23,140,439 (100)	9,112,997 (100)	25,565,502 (100)	69,341,939 (100)
Prostate cancer	426,263 (4)	1,132,448 (5)	468,081 (5)	1,219,427 (5)	3,246,219 (5)
Breast cancer	1,562,910 (14)	2,688,726 (12)	948,479 (10)	3,060,075 (12)	8,260,190 (12)
Other ST	8,826,955 (77)	16,983,244 (73)	6,644,151 (73)	19,338,117 (76)	51,792,468 (75)
MM	706,873 (6)	2,336,021 (10)	1,052,285 (12)	1,947,882 (8)	6,043,061 (9)
Productivity costs	710,355 (100)	15,702,107 (100)	1,099,437 (100)	5,571,418 (100)	23,083,317 (100)
Prostate cancer	56,936 (8)	2,178,026 (14)	34,468 (3)	591,565 (11)	2,860,995 (12)
Breast cancer	55,969 (8)	2,512,407 (16)	40,178 (4)	574,099 (10)	3,182,653 (14)
Other ST	272,648 (38)	9,417,410 (60)	133,091 (12)	2,615,608 (47)	12,438,757 (54)
MM	324,801 (46)	1,594,264 (10)	891,700 (81)	1,790,147 (32)	$4,600,912 (20)
All costs	174,604,527 (100)	779,084,451 (100)	120,111,658 (100)	281,805,763 (100)	1,355,606,399 (100)
Prostate cancer	22,724,627 (13)	126,202,132 (16)	17,716,888 (15)	45,295,221 (16)	211,938,869 (16)
Breast cancer	33,973,969 (19)	127,389,108 (16)	21,707,917 (18)	42,687,027 (15)	225,758,020 (17)
Other ST	110,715,708 (63)	477,200,434 (61)	65,917,658 (55)	180,597,032 (64)	834,430,831 (62)
MM	7,190,222 (4)	48,292,777 (6)	14,769,195 (12)	13,226,484 (5)	83,478,679 (6)

Abbreviations. LATAM, Latin America; MM, multiple myeloma; ST, solid tumors; SRE, skeletal-related event.

Figure 1. Burden of illness of SREs per 1,000 at risk in Argentina, Brazil, Colombia, and Mexico.

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