title: The economic burden of gastrointestinal stromal tumor (GIST) recurrence in patients who have received adjuvant imatinib therapy.
abstract: OBJECTIVE
  To estimate the economic burden of gastrointestinal stromal tumor (GIST) recurrence in patients who received imatinib adjuvant therapy.
  
  
  METHODS
  Data from the MarketScan and PharmMetrics databases between January 2000 and March 2013 were extracted. Patients who had received at least one diagnosis of GIST, had undergone a primary surgery for GIST, and had received at least one prescription for imatinib were included in the analysis. An algorithm was applied to identify those who had a subsequent GIST recurrence. Patients who experienced a recurrence and those who did not have a recurrence were compared for differences in healthcare utilization measures and healthcare costs within 6 months after the recurrence, while adjusting for potential confounding factors.
  
  
  RESULTS
  A total of 540 patients with primary resectable GIST who received imatinib adjuvant therapy were identified, including 444 (82.2%) patients who did not experience GIST recurrence and 96 (17.8%) patients who did experience recurrence. Patients who experienced GIST recurrence utilized significantly more healthcare resources in all categories than patients who did not have a recurrence, including the number of hospitalizations, days of hospitalization, emergency room visits, outpatient visits, and other medical services (all p-values <0.01). The total healthcare cost was significantly higher for patients with GIST recurrence, with a difference of $4464 per patient per month (p < 0.01). Both the medical and pharmacy costs were significantly higher with adjusted differences of $3488 and $1423 per patient per month, respectively (both p-values <0.01).
  
  
  CONCLUSIONS
  Patients who had GIST recurrence after surgical resection incurred significantly more healthcare resource utilization and greater healthcare costs within 6 months after the recurrence than patients who did not have recurrence. These findings suggest that GIST recurrence is associated with a substantial economic burden.
authors.affiliation: Analysis Group Inc. , Boston, MA , USA.
authors.forename: Annie
authors.initials: A
authors.lastname: Guerin
authors.forename: Medha
authors.initials: M
authors.lastname: Sasane
authors.forename: Genevieve
authors.initials: G
authors.lastname: Gauthier
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Keir
authors.forename: Maryia
authors.initials: M
authors.lastname: Zhdavana
authors.forename: Eric Q
authors.initials: EQ
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000191:economics* / Q000601:surgery; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D000068877:Imatinib Mesylate / Q000191:economics / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local
chemical_list: D000970:Antineoplastic Agents; D000068877:Imatinib Mesylate
keywords: Burden of recurrence; Gastrointestinal stromal tumors; Healthcare resource utilization and costs; Imatinib