title: Health resource utilization associated with skeletal-related events in patients with bone metastases: Results from a multinational retrospective - prospective observational study - a cohort from 4 European countries.
abstract: BACKGROUND
  Skeletal-related events (SREs; pathologic fracture, radiation or surgery to bone, spinal cord compression) frequently occur in patients with advanced cancer with bone metastases/lesions. Limited data on the associated patient and economic burden are available to aid in resource planning and evaluating treatment options.
  
  
  METHODS
  Patients with bone metastases/lesions secondary to breast, lung or prostate cancer or multiple myeloma; with at least one SRE within 97 days prior to enrollment; life expectancy of at least 6 months; and Eastern Cooperative Oncology Group performance status 0, 1 or 2 were recruited. Information on health resource utilization (HRU; including number/duration of hospitalizations, outpatient visits, procedures), attributed by investigators to be associated with a SRE, was collected retrospectively for up to 97 days prior to enrollment and prospectively for up to 18-21 months.
  
  
  RESULTS
  A total of 631 patients contributing 1282 SREs, were enrolled across Germany, Italy, Spain and the United Kingdom. Approximately a third of all SREs required an inpatient stay. Mean duration of inpatient stay for patients with SREs requiring one ranged from 8.4 to 41.1 days across all countries and SRE types.
  
  
  CONCLUSIONS
  All types of SREs are associated with substantial HRU burden. Preventing SREs by using the best therapeutic options available may help to reduce the burden to patients and healthcare systems.
authors.affiliation: Forschungsszentrum-ruhr, KliFoCenter GmbH, Pferdebachstr. 30, 58455 Witten, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Hoefeler
authors.affiliation: Hospital Universitario Virgen del Rocio, Avda. Manuel Siurot s/n, 41013 Seville, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Calle Ona 10, 28050 Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Duran
authors.affiliation: Health Economics, Amgen (Europe) GmbH, Dammstrasse 23, 6301 Zug, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Hechmati
authors.affiliation: Institut Català d׳Oncologia, Avinguda Gran Via de L׳Hospitalet, 199-203, 08908 L׳Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Garzon Rodriguez
authors.affiliation: Universitätsmedizin Berlin, Charité Campus Benjamin Franklin, Charitéplatz 1, D-10117 Berlin, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Lüftner
authors.affiliation: Pinderfields Hospital, Mid Yorkshire Hospitals NHS Trust, Wakefield WF1 4DG, UK.
authors.forename: J
authors.initials: J
authors.lastname: Ashcroft
authors.affiliation: Bristol Haematology and Oncology Centre, University Hospitals Bristol, Bristol BS2 8ED, UK.
authors.forename: A
authors.initials: A
authors.lastname: Bahl
authors.affiliation: Health Economics, Amgen Inc., 1 Amgen Center Drive, Thousand Oaks, CA 91320, USA.
authors.forename: C
authors.initials: C
authors.lastname: Atchison
authors.affiliation: Biostatistics, Amgen Inc., 1 Amgen Center Drive, Thousand Oaks, CA 91320, USA.
authors.forename: R
authors.initials: R
authors.lastname: Wei
authors.affiliation: Scientific Affairs, Amgen (Europe) GmbH, Dammstrasse 23, 6301 Zug, Switzerland.
authors.forename: E
authors.initials: E
authors.lastname: Thomas
authors.affiliation: Oncology Institute ASL, Via Antonio Miglietta, 5, 73100 Lecce, Province of Lecce, Italy; National Cancer Institute, Istituto Oncologico Giovanni Paolo II, Viale Orazio Flacco 65, 70124 Bari, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Lorusso
keywords: Advanced cancer; Bone metastases; ECOG, Eastern Cooperative Oncology Group; HRU, health resource utilization; Health resource utilization; Observational research; SRE, skeletal-related event; Skeletal-related event