title: Healthcare resource use in advanced prostate cancer patients treated with docetaxel.
abstract: OBJECTIVE
  Although the treatment of metastatic castrate-resistant prostate cancer (mCRPC) has improved with newer therapies, there is little understanding how these therapies have impacted resource use and associated expenditures; available estimates are dated. The current study examined contemporary healthcare utilization and associated costs for mCRPC patients and how these measures changed over time.
  
  
  METHODS
  This retrospective cohort analysis used medical and pharmaceutical insurance claims data from a large non-payer-owned integrated claims database of US commercial insurers. Amongst all patients with a prostate cancer diagnosis (n=256,464), those with ≥ 1 docetaxel claim (docetaxel cohort, n=3642) were identified as mCRPC patients. Within the docetaxel cohort, an additional 6-months follow-up cohort (n=2862) was identified, i.e., patients with at least 6 months of follow-up after the first docetaxel claim. Resource utilization and costs were identified for all-cause hospitalizations, emergency room (ER) visits, physician visits and ambulatory visits, and prostate cancer-related prescription treatments.
  
  
  RESULTS
  Significant increases in the mean per-patient-per-month (PPPM) count for the docetaxel cohort were observed for all medical resources measured (hospitalizations and ER, physician, and ambulatory visits) in the post-docetaxel period compared with the pre-docetaxel period (p<0.0001); similar significant increases were observed for the 6-months follow-up cohort in the last 6 months (prior to lost to follow-up date) compared with the period preceding the last 6 months (p<0.0408 ambulatory visits, p<0.0001 all other resources). Total docetaxel cohort costs (mean [standard deviation]) rose from an average PPPM cost of US$2593 (3208) in the pre-docetaxel period to US$5847 (6990) in the post-docetaxel period (p<0.0001); each of the individual resources measured (hospitalization, all healthcare visits, and prescription costs) demonstrated significant increases (p<0.0001).
  
  
  CONCLUSIONS
  Retrospective study design.
  
  
  CONCLUSIONS
  This large database analysis showed a significant increase in use of healthcare resources and associated costs among mCRPC patients following first-line docetaxel treatment.
authors.affiliation: Janssen Global Services, Raritan, NJ 08869, USA. mmehra@its.jnj.com
authors.forename: Maneesha
authors.initials: M
authors.lastname: Mehra
authors.forename: Ying
authors.initials: Y
authors.lastname: Wu
authors.forename: Ravinder
authors.initials: R
authors.lastname: Dhawan
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D000077143:Docetaxel; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000473:pathology; D012189:Retrospective Studies; D043823:Taxoids / Q000191:economics* / Q000627:therapeutic use; D014481:United States
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel