Burden of illness of bone metastases in prostate cancer patients in Québec, Canada: A population-based analysis

  • Louise Perrault International Market Access Consulting
  • Vincent Fradet Centre de Recherche du CHU de Québec
  • Véronique Lauzon International Market Access Consulting
  • Jacques LeLorier Centre Hospitalier de l'Université de Montréal
  • Dominic Mitchell International Market Access Consulting
  • Mohdhar Habib Amgen Canada Inc.
Keywords: prostate cancer, bone metastasis, skeletal-related events, costs, healthcare resource use

Abstract

Introduction: Metastasis of prostate cancer (PC) to bone (metastatic bone disease, MBD) increases morbidity, but Canadian data are lacking on the associated healthcare resource utilization (HCRU) and costs. We quantified MBD-related HCRU and associated costs in this population, and assessed skeletal-related events (SREs), such as pathologic fracture, spinal cord compression, bone radiotherapy, and bone surgery.

Methods: We conducted a retrospective, population-based cohort study using the Québec health insurance agency database. Prescription drug and medical services data were retrieved for patients with ≥1 healthcare claim in 2001 with a PC diagnosis (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] code of 185.xx). Patients with ≥2 MBDrelated claims or an SRE were compared with a matched-control group of PC patients without MBD. Patients were followed until death, loss to follow-up, or the end of available data (August 31, 2010). Costs (in 2012 Canadian dollars) were adjusted for age, year of MBD diagnosis, general health status, and baseline resource utilization.

Results: Compared with controls (n = 1671), MBD patients (n = 626) had significantly higher HCRU. Adjusted mean (95% confidence interval) all-cause healthcare costs were $11 820 (7248–16 058) higher, and MBD-related costs were $3 091 (1267–4861) higher in MBD patients than in controls. Nearly 50% of MBD patients received radiotherapy within 2.5 years of their MBD diagnosis, but most exited the study without experiencing other SREs.

Conclusion: MBD imposes a heavy HCRU and cost burden among patients with PC in Canada. Effective therapy is needed to reduce the clinical and economic impact of MBD in this population.

Published
2015-10-13
How to Cite
Perrault, L., Fradet, V., Lauzon, V., LeLorier, J., Mitchell, D., & Habib, M. (2015). Burden of illness of bone metastases in prostate cancer patients in Québec, Canada: A population-based analysis. Canadian Urological Association Journal, 9(9-10), 307-14. https://doi.org/10.5489/cuaj.2707
Section
Original Research