Health resource utilisation associated with skeletal-related events in European patients with lung cancer: Α subgroup analysis from a prospective multinational study

Abstract

Abstract. Bone complications or skeletal-related events (SREs), typically defined as radiation to bone, pathological fractures, surgery to bone and spinal cord compression, occur frequently in patients with bone metastases. As the survival of patients with advanced lung cancer improves, preventing SREs is becoming increasingly clinically relevant. The aim of this analysis was to assess the impact of SREs on health resource utilisation (HRU) in European lung cancer patients with bone metastasis. This multinational, observational study included patients who had at least one SRE in the 97 days prior to enrolment, a life expectancy of ≥6 months and an Eastern Cooperative Oncology Group performance status of 0-2. Data on HRU were retrospectively collected for up to 97 days prior to enrolment with a planned prospective follow-up for up to 18-21 months. The HRU measures included the number and length of inpatient hospitalisations and the number of outpatient visits and procedures. The investigators determined whether each HRU was attributable to a SRE. In total, 135 patients with lung cancer, enrolled at centres in Germany, Italy, Spain and the United Kingdom, contributed 214 SREs to this analysis. The median length [quartile (Q)1, Q3] of follow-up ranged from 1.5 (0.7, 3.3) to 5.6 (2.0, 8.2) months across the countries. Overall, 41% of the SREs required an inpatient stay, with a median (Q1, Q3) duration of 19.0 (6.0, 28.0) days. Spinal cord compression and surgery to bone were the SRE types most frequently requiring inpatient stays. Radiation to bone was associated with the largest number of outpatient visits and procedures. All the SREs resulting from bone metastases in patients with lung cancer contribute considerably to HRU and efforts to minimise the incidence of bone complications in these patients through appropriate treatments may help reduce this burden.

Healthcare resource utilisation associated with skeletal‐related events in European patients with multiple myeloma: Results from a prospective, multinational, observational study

“…This is a smaller proportion than in patients with other cancer types (lung cancer, 80%; prostate cancer, 74%; breast cancer, 58%). [14][15][16] The reasons for this difference are unclear and are beyond the scope of this study, but a speculative explanation could be that the threshold to initiate imag- Outpatient visits were necessary for the majority of SREs (63.7%) and were most frequently required for radiation to bone (74.8%) and vertebral fracture (73.3%). In the UK, the mean number of outpatient visits required per SRE was less than one-third of that of the overall mean.…”

“…Nevertheless, the data presented here indicate that outpatient visits impose a considerable burden on healthcare resources in Europe, similar to findings reported for other cancer types in this study. 3,[14][15][16] This study has identified that almost every SRE required a procedure, and multiple procedures were common. Overall, a mean of 7.4 procedures per SRE was required.…”

“…Data on the HRU associated with SREs in breast cancer, lung cancer and prostate cancer in the four European countries (Germany, Italy, Spain and the UK) have been previously reported. [14][15][16] Here, we report the European data for patients with MM.…”

Hospitalizations for fracture in patients with metastatic disease: primary source lesions in the United States

“…Two classes of medications, the RANK-ligand inhibitors and bisphosphonates, reduce the number of skeletal events, such as pathologic fracture, in patients with metastatic disease to bone. [23][24][25][26] However, most of those studies focused on the 3 most common carcinomas (breast, lung, and prostate) to metastasize to bone and cause pathologic fracture. ere is greater variability in the prophylactic treatment of other forms of cancer that have metastasized to bone amongst oncologists.…”

Therapeutic Potential of Denosumab in Patients With Lung Cancer: Beyond Prevention of Skeletal Complications

“…26 In a European study in lung cancer patients with at least 1 SRE, 41% of the events required hospitalization during a median of 19 days. 27 In several studies from Germany, 28 Spain, 28,29 Italy, 28 the United Kingdom, 28 Portugal, 30 and Belgium, 31 costs of each SRE were in the following ranges: pathologic fractures: V4712 to V8730; radiation to bone, V1485 to V3877; spinal cord compression: V7903 to V13,203; and surgery to bone: V3348 to V12,092. In a French study of 554 lung cancer patients with bone metastasis, 49.5% of yearly costs related to bone metastasis could be assigned to SREs.…”