title: Hospital resource utilization and treatment cost of skeletal-related events in patients with metastatic breast or prostate cancer: estimation for the Portuguese National Health System.
abstract: BACKGROUND
  Skeletal-related events (SREs) occur frequently in patients with bone metastases as a result of breast (BC) and prostate (PC) cancers. They increase both morbidity and mortality and lead to extensive health-care resource utilization.
  
  
  METHODS
  Health care resource utilization by BC/PC patients with at least one SRE during the preceding 12 months was assessed through retrospective chart review. SRE-treatment costs were estimated using the Portuguese Ministry of Health cost database and analyzed using generalized linear models.
  
  
  RESULTS
  This study included 152 patients from nine hospitals. The mean (SD) annual SRE-treatment cost per patient was €5963 (€3646) and €5711 (€4347), for BC (n=121) and PC (n=31) patients, respectively. Mean cost per single episode ranged between €1485 (radiotherapy) and €13,203 (spinal cord compression). Early onset of bone metastasis (P = 0.03) and diagnosis of bone metastases at or after the occurrence of the first SRE (P < 0.001) were associated with higher SRE-treatment costs.
  
  
  CONCLUSIONS
  These results reveal the high hospital SRE-treatment costs, highlighting the need for early diagnosis and treatment, and identify key factors determining the economic value of therapies for patients with skeletal metastases.
authors.affiliation: Exigo Consultores, Alhos Vedros, Portugal. jorge.felix@exigoconsultores.com
authors.forename: J
authors.initials: J
authors.lastname: Félix
authors.forename: V
authors.initials: V
authors.lastname: Andreozzi
authors.forename: M
authors.initials: M
authors.lastname: Soares
authors.forename: P
authors.initials: P
authors.lastname: Borrego
authors.forename: H
authors.initials: H
authors.lastname: Gervásio
authors.forename: A
authors.initials: A
authors.lastname: Moreira
authors.forename: L
authors.initials: L
authors.lastname: Costa
authors.forename: F
authors.initials: F
authors.lastname: Marcelo
authors.forename: F
authors.initials: F
authors.lastname: Peralta
authors.forename: I
authors.initials: I
authors.lastname: Furtado
authors.forename: F
authors.initials: F
authors.lastname: Pina
authors.forename: C
authors.initials: C
authors.lastname: Albuquerque
authors.forename: A
authors.initials: A
authors.lastname: Santos
authors.forename: J L
authors.initials: JL
authors.lastname: Passos-Coelho
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000191:economics* / Q000556:secondary / Q000628:therapy; D001943:Breast Neoplasms / Q000191:economics* / Q000628:therapy; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics*; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D011174:Portugal; D011471:Prostatic Neoplasms / Q000191:economics* / Q000628:therapy; D012189:Retrospective Studies