title: Clinical and economic burden of bone metastasis and skeletal-related events in prostate cancer.
abstract: OBJECTIVE
  We review the clinical trials and observational studies literature regarding the clinical and economic burden of bone metastasis and skeletal-related events (SREs) in prostate cancer, and discuss current gaps in understanding the impact of bone metastasis in this disease.
  
  
  RESULTS
  Trial data indicate that SREs occur in half of prostate cancer patients with bone metastasis in the absence of treatment, and 30-45% among those who receive bone-modifying agents. In the United States, the cost of SRE ranged from $7553 per radiation episode to $88 838 per bone surgery episode. Prevalence of SRE, time to SRE occurrence, and cost of SRE varied across studies because of differences in study populations, follow-up period, and the algorithm used to measure SRE. There is limited evidence on the clinical and economic impact by SRE subtype. Information regarding patient-reported outcomes and costs from the patient's perspective is lacking.
  
  
  CONCLUSIONS
  Bone metastasis and SREs in prostate cancer patients are associated with considerable morbidity, reduced survival, and substantial economic burden. Consistent study methodology, particularly the measurement of SREs, is necessary to allow comparison of estimates across studies. The inclusion of patient-centered clinical and economic outcomes in future research will provide pertinent information regarding the burden of bone metastasis and SREs.
authors.affiliation: University of Maryland School of Pharmacy, Baltimore, Maryland, USA.
authors.forename: Candice
authors.initials: C
authors.lastname: Yong
authors.forename: Eberechukwu
authors.initials: E
authors.lastname: Onukwugha
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Mullins
mesh_terms: D001859:Bone Neoplasms / Q000191:economics / Q000556:secondary*; D002986:Clinical Trials as Topic; D017281:Cost of Illness; D050723:Fractures, Bone / Q000191:economics* / Q000209:etiology; D017048:Health Care Costs; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000191:economics / Q000473:pathology*; D013117:Spinal Cord Compression / Q000191:economics* / Q000209:etiology