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Comparing costs and health care resource utilization between nmHSPC and mHSPC patients: a retrospective claims analysis.

BACKGROUND: Prostate cancer is common among men in the United States, and hormone sensitive-prostate cancer (HSPC) is the predominant etiology. However, there is a paucity of evidence documenting the financial… Click to show full abstract

BACKGROUND: Prostate cancer is common among men in the United States, and hormone sensitive-prostate cancer (HSPC) is the predominant etiology. However, there is a paucity of evidence documenting the financial impact of metastatic disease within this etiology. OBJECTIVE: To estimate the differences in health care resource utilization (HCRU) and costs for patients with nonmetastatic HSPC (nmHSPC) and metastatic HSPC (mHSPC) and their payers. METHODS: We conducted a retrospective cohort analysis using claims data from the IBM MarketScan databases from January 2016 to December 2019. HSPC was defined as having at least 1 inpatient services or 2 outpatient services claims with a prostate cancer diagnosis and a claim for androgen deprivation therapy use within 6 months of the initial diagnostic claim. Metastatic patients had a secondary diagnosis code of metastasis with their initial diagnostic claim. We compared mean 12-month HCRU, patient out-of-pocket (OOP), and payer costs between patients with nmHSPC and mHSPC using multivariable linear regression. RESULTS: 4,329 patients met the study inclusion criteria, 600 of which had mHSPC. Patients with mHSPC had more outpatient prescription fills (10.91 additional fills; 95% CI = 8.09-13.99) and outpatient services visits (10.61 additional visits; 95% CI = 8.38-13.04) but similar other HCRU. The overall 12-month costs of patients with mHSPC were significantly greater than patients with nmHSPC for patient OOP ($1,244; 95% CI = $1,004-$1,513) and payers ($113,725; 95% CI = $91,494-$141,127). CONCLUSIONS: Compared with patients with nmHSPC, individuals with mHSPC incur greater HCRU and significant personal and overall financial burden. DISCLOSURES: This study had no outside funding support. The authors have nothing to disclose.

Keywords: mhspc; care resource; etiology; care; resource utilization; health care

Journal Title: Journal of managed care & specialty pharmacy
Year Published: 2022

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