title: Burden and treatment patterns of advanced basal cell carcinoma among commercially insured patients in a United States database from 2010 to 2014.
abstract: BACKGROUND
  The burden of advanced basal cell carcinoma (aBCC) is not fully understood.
  
  
  OBJECTIVE
  To compare BCC disease burden and treatment patterns for aBCC with those for non-aBCC.
  
  
  METHODS
  A retrospective, insurance claims-based study design was used. Adults with ≥2 claims associated with a BCC diagnosis (ICD-9-CM 173.x1) separated by ≥30 days on or after October 1, 2011, were classified as aBCC or non-aBCC by using an algorithm based on metastasis diagnosis, radiation therapy use, and medical oncologist/other specialist use. Non-aBCC and aBCC patients were matched 1:1 on the basis of age, sex, and region, and assigned the same index date (date of first qualifying diagnosis or event). Comparisons were made using Wilcoxon signed-rank (continuous variables) and McNemar's (categorical variables) tests.
  
  
  RESULTS
  In total, 847 matched aBCC/non-aBCC patient pairs were selected (mean age 75 years; 57% men; locally advanced BCC, n = 826; metastatic BCC, n = 21). During the 12-month study period following the index date, aBCC patients had a significantly higher mean Charlson Comorbidity Index (P = .0023), significantly higher mean numbers of outpatient/dermatologist/medical oncologist visits (all P < .0001), and significantly higher mean total/medical/inpatient/outpatient/BCC treatment costs (all P < .05).
  
  
  CONCLUSIONS
  This study only included information from a database on commercial insurance and Medicare claims. The algorithm criteria might have restricted patient numbers; data were not fully reflective of targeted therapy era.
  
  
  CONCLUSIONS
  aBCC patients had a higher disease burden than non-aBCC patients. Cost differences were largely driven by higher BCC treatment costs, specifically radiation therapy.
authors.affiliation: Mohs Surgery Center, Departments of Dermatology and Head and Neck Surgery, The University of Texas - MD Anderson Cancer Center, Houston, Texas. Electronic address: mrmigden@mdanderson.org.
authors.forename: Michael
authors.initials: M
authors.lastname: Migden
authors.affiliation: Analysis Group, Inc, New York, New York.
authors.forename: Jipan
authors.initials: J
authors.lastname: Xie
authors.affiliation: Analysis Group, Inc, New York, New York.
authors.forename: Jin
authors.initials: J
authors.lastname: Wei
authors.affiliation: Analysis Group, Inc, New York, New York.
authors.forename: Wenxi
authors.initials: W
authors.lastname: Tang
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, New Jersey.
authors.forename: Vivian
authors.initials: V
authors.lastname: Herrera
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, New Jersey.
authors.forename: Jacqueline B
authors.initials: JB
authors.lastname: Palmer
mesh_terms: D000368:Aged; D000465:Algorithms; D002280:Basal Cell Carcinoma / Q000191:economics / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D017281:Cost of Illness; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007348:Insurance, Health; D008297:Male; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000191:economics / Q000473:pathology / Q000628:therapy*; D013997:Time Factors; D014481:United States
keywords: basal cell carcinoma; burden; costs; healthcare utilization; treatment