title: Impact of skeletal complications on total medical care costs among patients with bone metastases of lung cancer.
abstract: BACKGROUND
  Previous studies have estimated the costs of skeletal-related events (SREs) for patients with bone metastases of solid tumors by tallying costs for services specifically attributable to these events. This approach may underestimate costs if SREs indirectly increase use of other services.
  
  
  METHODS
  This is a retrospective observational study using a large health insurance claims database. Patients with bone metastases of lung cancer who experienced > or =1 SRE were matched to similar patients without SREs based on propensity scores. Kaplan-Meier estimated total medical care costs were compared for propensity-matched samples of patients with SREs and without SREs.
  
  
  RESULTS
  We identified 534 patients with lung cancer and bone metastases, including 295 (55%) with > or =1 SRE. After matching, there were 162 patients each in the SRE and no-SRE groups with mean follow-up of 5.3 and 3.9 months, respectively. In the SRE group, costs of treatment of SREs were $9,480 (95% CI $7,625 to $11,374) per patient. Total medical care costs were $27,982 (95% CI $15,921 to $40,625) greater for SRE versus no-SRE patients (p < 0.001).
  
  
  CONCLUSIONS
  The costs of SREs in patients with lung cancer and bone metastases are substantial and potentially greater than previously estimated.
authors.affiliation: Policy Analysis Inc., Brookline, MA 02445, USA. tdelea@pai2.com
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Delea
authors.forename: James
authors.initials: J
authors.lastname: McKiernan
authors.forename: Jane
authors.initials: J
authors.lastname: Brandman
authors.forename: John
authors.initials: J
authors.lastname: Edelsberg
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sung
authors.forename: Monika
authors.initials: M
authors.lastname: Raut
authors.forename: Gerry
authors.initials: G
authors.lastname: Oster
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000191:economics* / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D016022:Case-Control Studies; D003131:Combined Modality Therapy / Q000191:economics; D016001:Confidence Intervals; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D038801:International Classification of Diseases; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000191:economics* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment