In-Hospital Economic Burden of Metastatic Renal Cell Carcinoma in France in the Era of Targeted Therapies: Analysis of the French National Hospital Database from 2008 to 2013

Abstract

Background & ObjectivesThe aim of this study was to assess the economic burden of hospitalisations for metastatic renal cell carcinoma (mRCC), to describe the patterns of prescribing expensive drugs and to explore the impact of geographic and socio-demographic factors on the use of these drugs.MethodsWe performed a retrospective analysis from the French national hospitals database. Hospital stays for mRCC between 2008 and 2013 were identified by combining the 10th revision of the International Classification of Diseases (ICD-10) codes for renal cell carcinoma (C64) and codes for metastases (C77 to C79). Incident cases were identified out of all hospital stays and followed till December 2013. Descriptive analyses were performed with a focus on hospital stays and patient characteristics. Costs were assessed from the perspective of the French National Health Insurance and were obtained from official diagnosis-related group tariffs for public and private hospitals.ResultsA total of 15,752 adult patients were hospitalised for mRCC, corresponding to 102,613 hospital stays. Of those patients, 68% were men and the median age at first hospitalisation was 69 years [Min-Max: 18–102]. Over the study period, the hospital mortality rate reached 37%. The annual cost of managing mRCC at hospital varied between 28M€ in 2008 and 42M€ in 2012 and was mainly driven by inpatient costs. The mean annual per capita cost of hospital management of mRCC varied across the study period from 8,993€ (SD: €8,906) in 2008 to 10,216€ (SD: €10,527) in 2012. Analysis of the determinants of prescribing expensive drugs at hospital did not show social or territorial differences in the use of these drugs.ConclusionThis study is the first to investigate the in-hospital economic burden of mRCC in France. Results showed that in-hospital costs of managing mRCC are mainly driven by expensive drugs and inpatient costs.

Management of Patients with Pancreatic Ductal Adenocarcinoma in the Real-Life Setting: Lessons from the French National Hospital Database

“…The present study reports a high incidence of PDAC (22.6 per 100,000 PY) in AuRA region in 2016, which represents 13% of the total number in France during 2016. Studies in breast, prostate, and colorectal cancers have already showed that incidence estimated from the PMSI database was close to that of registries, which supports the robustness of our data [ 18 , 19 ]. In the present study, several crucial information about the “real-life” management of PDAC patients in AuRA can be extracted.…”

Real life patterns of care and progression free survival in metastatic renal cell carcinoma patients: retrospective analysis of cross-sectional data

“…This study assessed real world treatment patterns and outcomes in patients with mRCC. Patient characteristics in terms of age, sex and histology are consistent with the known disease epidemiology [ 9 , 10 ]. Nevertheless, the proportion of patients initially diagnosed with metastatic disease is higher than previously published figures.…”

Economic Burden of Renal Cell Carcinoma—Part I: An Updated Review

“…The approval of several targeted therapy agents for mRCC has motivated researchers to study the economic impact of these costly agents on this particular disease stage of RCC. Although this topic was explored in five studies, [70][71][72][73][74] comparing economic burden estimated from these studies was not meaningful because of differences in the study cohorts and variations in cost structure across countries, as well as what was captured in costs. Ballali and colleagues estimated the population economic burden for mRCC patients in Italy but restricted their study to the clinical scenario of using sunitinib and sorafenib as first-and second-line treatment, respectively.…”

“…The study concluded that although the mean hospitalization cost per patient continued to increase over time, the proportion of patients receiving expensive IV drugs in hospital setting has decreased as a result of increasing use of targeted oral anticancer drugs. [72] Another French study estimated per patient per month (PPPM) costs for mRCC patients receiving targeted therapies as first-line treatment and reported that costs of targeted oral agents accounted for more than 50% of the estimated total PPPM cost of €5,546 [$6,944]. [71] From the societal perspective, Purmonen and colleagues estimated the lifetime treatment costs of mRCC patients who received IFNα as first-line treatment and conducted budget impact modeling to project the impact of adding sunitinib to the 1st-line treatment protocol on the five year costs of mRCC in Finland.…”