title: Healthcare resource use and costs associated with renal impairment in US patients with bone metastases from solid tumors.
abstract: Introduction During cancer progression, more than half of patients develop renal insufficiency, including chronic kidney disease. The primary and secondary objectives of this study were to estimate healthcare resource use and costs, respectively, associated with renal impairment in patients with bone metastases from solid tumors in the United States. Methods and materials This was a retrospective, observational cohort study conducted using administrative claims data for individuals with solid tumors and bone metastases. Control patients were matched to renal impairment patients using propensity scores (ratio up to 3:1) based on demographics, clinical characteristics, and baseline costs. Average per-patient per-year healthcare resource utilization and costs (total costs and cost components; 2013 dollars) were reported. Results In total, 2616 renal impairment patients were matched to 7211 control patients. Renal impairment patients had greater healthcare resource use compared with controls, including a greater mean number of hospital admissions (4.4 versus 2.1), longer average stay per hospital admission (7.4 versus 6.5 days), as well as greater mean number of physician office visits (22.9 versus 18.8), emergency department visits (3.1 versus 2.0), and hospital-based outpatient visits (18.8 versus 16.0) compared with control patients. Total costs were > $50,000 higher among renal impairment patients ($142,267 versus $88,839; P < 0.001), with hospital costs accounting for $72,557 for renal impairment patients, and $27,858 for control patients ( P < 0.001). Conclusion The healthcare resource use and costs associated with renal impairment in patients with bone metastases from solid tumors is high; efforts to reduce renal impairment in this population, including the potential avoidance of nephrotoxic agents, are warranted.
authors: 1 Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, USA.
authors: Yi
authors: Y
authors: Qian
authors: 1 Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, USA.
authors: Jorge
authors: J
authors: Arellano
authors: 1 Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, USA.
authors: Debajyoti
authors: D
authors: Bhowmik
authors: 2 Truven Health Analytics, Cambridge, MA, USA.
authors: Erin
authors: E
authors: Thomson
authors: 2 Truven Health Analytics, Cambridge, MA, USA.
authors: David M
authors: DM
authors: Smith
authors: 3 Amgen (Europe) GmbH, Zug, Switzerland.
authors: Guy
authors: G
authors: Hechmati
authors: 2 Truven Health Analytics, Cambridge, MA, USA.
authors: Xue
authors: X
authors: Song
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000191:economics*; D003695:Delivery of Health Care / Q000191:economics*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000191:economics*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000191:economics*; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult
keywords: Renal impairment; bone metastasis; solid tumors