title: Estimating costs of care for patients with newly diagnosed metastatic colorectal cancer.
abstract: BACKGROUND
  This study examines the resource use patterns and costs of care for patients with incident metastatic colorectal cancer (mCRC) based on analyses of retrospective claims data from selected health plans in the United States.
  
  
  METHODS
  A case-control analysis was performed using claims from years 1998-2004. Incident mCRC cases were identified based on evidence of a colorectal cancer diagnosis and a metastatic disease diagnosis. Incident mCRC cases could have no other evidence of cancer in the 1-year period before the date of their first mCRC diagnosis. Cases were matched to non-mCRC controls based on age, sex, geographic region, and duration of plan enrollment. Costs were evaluated by phase of disease: diagnosis, treatment, or death phases. Ordinary least squares regressions were performed to evaluate impact of covariates in each phase.
  
  
  RESULTS
  Total costs in the follow-up period averaged $97,031 more for mCRC cases than for controls. The main cost drivers for mCRC were hospitalizations ($37,369) and specialist visits ($34,582), which included chemotherapy administration. Approximately 40% of the 672 patients with mCRC who qualified for the phase analysis were identified with a fatal event during follow-up. Monthly costs were similar in the diagnostic phase ($12,205) and death phase ($12,328), but were significantly lower in the treatment phase ($4722). Both mean/median monthly costs increased over time during the study period, regardless of disease phase.
  
  
  CONCLUSIONS
  The economic burden of mCRC is substantial for patients with commercial health plans in the United States, and costs of care have increased substantially in recent years.
authors.affiliation: Center for Health Economics & Policy, United BioSource Corporation, Bethesda, MD 20814, USA clark.paramore@unitedbiosource.com
authors.forename: L Clark
authors.initials: LC
authors.lastname: Paramore
authors.forename: Simu K
authors.initials: SK
authors.lastname: Thomas
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Knopf
authors.forename: Lael S
authors.initials: LS
authors.lastname: Cragin
authors.forename: Kathy H
authors.initials: KH
authors.lastname: Fraeman
mesh_terms: D016022:Case-Control Studies; D015179:Colorectal Neoplasms; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis; D014481:United States