title: Frequency of skeletal-related events and associated healthcare resource use and costs in US patients with multiple myeloma.
abstract: OBJECTIVE
  A potential complication for all new multiple myeloma (MM) patients is the clinical presentation of osteolytic lesions which increase the risk for skeletal-related events (SREs). However, the contribution of SREs to the overall economic impact of MM is unclear. The impact of SREs on healthcare resource utilization (HCRU) and costs for US patients with MM was analyzed in Truven Health Marketscan Commercial Claims and Medicare Supplemental Databases.
  
  
  METHODS
  Adults diagnosed with MM between January 1, 2005 and December 31, 2010 with ≥2 claims ≥30 days apart (first claim = index date) were included. SREs included: hypercalcemia, pathologic fracture, surgery for the prevention and treatment of pathologic fractures or spinal cord compression, and radiation for bone pain. Rates of HCRU (outpatient [OP], inpatient [IP], emergency room [ER], orthopedic consultation [OC], and ancillary) and healthcare costs were compared between MM patients with and without SREs. Inverse propensity weighting was applied to adjust for potential bias.
  
  
  RESULTS
  Of 1028 MM patients (mean age = 67, standard deviation = 13.2), 596 patients with ≥1 SRE and 432 without SREs were assessed. HCRU rates in IP, ER, and ancillary (p < 0.01) and mean total costs of OP, IP, and ER were significantly higher (p < 0.05) for patients with vs without SREs during follow-up. HCRU rates also increased with SRE frequency (p < 0.05 in OP, IP, ER, OC, and ancillary), as did mean total healthcare costs, except for OC (p < 0.001).
  
  
  CONCLUSIONS
  A broad assessment of pharmacotherapy for the treatment of MM was not an objective of the current study. Bisphosphonate use was evaluated; however, results were descriptively focused on frequency of utilization only and were not included in the broader cost and HCRU analysis.
  
  
  CONCLUSIONS
  Among US patients with MM, higher SRE frequency was associated with a significant trend of higher HCRU and total healthcare costs in several settings.
authors.affiliation: a Eli Lilly and Company , Indianapolis , IN , USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Nash Smyth
authors.affiliation: a Eli Lilly and Company , Indianapolis , IN , USA.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Conti
authors.affiliation: a Eli Lilly and Company , Indianapolis , IN , USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Wooldridge
authors.affiliation: a Eli Lilly and Company , Indianapolis , IN , USA.
authors.forename: Lee
authors.initials: L
authors.lastname: Bowman
authors.affiliation: a Eli Lilly and Company , Indianapolis , IN , USA.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: a Eli Lilly and Company , Indianapolis , IN , USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Nelson
authors.affiliation: a Eli Lilly and Company , Indianapolis , IN , USA.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Ball
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D005598:Fractures, Spontaneous / Q000191:economics* / Q000209:etiology / Q000601:surgery; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy / Q000191:economics* / Q000209:etiology; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000191:economics; D010146:Pain / Q000188:drug therapy / Q000191:economics* / Q000532:radiotherapy; D013117:Spinal Cord Compression / Q000188:drug therapy / Q000191:economics* / Q000209:etiology; D014481:United States; D055815:Young Adult
chemical_list: D004164:Diphosphonates
keywords: Costs; Multiple myeloma; Skeletal-related event; Utilization