title: Health resource utilisation associated with skeletal-related events in European patients with lung cancer: Α subgroup analysis from a prospective multinational study.
abstract: Bone complications or skeletal-related events (SREs), typically defined as radiation to bone, pathological fractures, surgery to bone and spinal cord compression, occur frequently in patients with bone metastases. As the survival of patients with advanced lung cancer improves, preventing SREs is becoming increasingly clinically relevant. The aim of this analysis was to assess the impact of SREs on health resource utilisation (HRU) in European lung cancer patients with bone metastasis. This multinational, observational study included patients who had at least one SRE in the 97 days prior to enrolment, a life expectancy of ≥6 months and an Eastern Cooperative Oncology Group performance status of 0-2. Data on HRU were retrospectively collected for up to 97 days prior to enrolment with a planned prospective follow-up for up to 18-21 months. The HRU measures included the number and length of inpatient hospitalisations and the number of outpatient visits and procedures. The investigators determined whether each HRU was attributable to a SRE. In total, 135 patients with lung cancer, enrolled at centres in Germany, Italy, Spain and the United Kingdom, contributed 214 SREs to this analysis. The median length [quartile (Q)1, Q3] of follow-up ranged from 1.5 (0.7, 3.3) to 5.6 (2.0, 8.2) months across the countries. Overall, 41% of the SREs required an inpatient stay, with a median (Q1, Q3) duration of 19.0 (6.0, 28.0) days. Spinal cord compression and surgery to bone were the SRE types most frequently requiring inpatient stays. Radiation to bone was associated with the largest number of outpatient visits and procedures. All the SREs resulting from bone metastases in patients with lung cancer contribute considerably to HRU and efforts to minimise the incidence of bone complications in these patients through appropriate treatments may help reduce this burden.
authors: Oncology Institute ASL, Lecce, Italy ; National Cancer Institute IRCCS Giovanni Paolo II, Bari, Italy.
authors: Vito
authors: V
authors: Lorusso
authors: Centro Integral Oncologica Clara Campal (CIOCC), Madrid, Spain ; University Hospital Virgen del Rocio, Seville, Spain.
authors: Ignacio
authors: I
authors: Duran
authors: Catalan Institute of Oncology (ICO) - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
authors: Cristina
authors: C
authors: Garzon-Rodriguez
authors: Berlin University of Medicine, Berlin, Germany.
authors: Diana
authors: D
authors: Lüftner
authors: University Hospitals Bristol, Bristol, UK.
authors: Amit
authors: A
authors: Bahl
authors: Pinderfields General Hospital, Wakefield, UK.
authors: John
authors: J
authors: Ashcroft
authors: Health Economics, Amgen (Europe) GmbH, Zug, Switzerland.
authors: Guy
authors: G
authors: Hechmati
authors: Department of Biostatistics, Amgen, Inc., Thousand Oaks, CA, USA.
authors: Rachel
authors: R
authors: Wei
authors: Scientific Publications, Amgen (Europe) GmbH, Zug, Switzerland.
authors: Emma
authors: E
authors: Thomas
authors: Research Center Ruhr, Witten, Germany.
authors: Herbert
authors: H
authors: Hoefeler
keywords: Europe; bone metastases; disease burden; healthcare resource utilisation; lung cancer; skeletal-related events