Resource use and costs before and after taxane chemotherapy (CT) in commercially-insured men with metastatic prostate cancer (PC)

Methods: A retrospective analysis using Thomson Reuters MarketScan® Database identified commercially-insured men aged ≥18 years with an initial metastatic cancer claim (MC) between 7/1/2005-12/31/2008, a PC claim 90 days before or on MC, and ≥1 MC and ≥1 PC claim in the 540 days after initial MC. Men with other cancers or prior CT were excluded. From this pool, patients with a first taxane CT claim (index) in the 540 days post-MC and with 180 days pre- and post-index continuous enrollment were selected. Resource use and reimbursed costs (2010 US$) in the 180 days pre- and post-index were assessed. Results: There were 92 men with metastatic PC and taxane use (mean age=58.5 years). Non-opioid, weak opioid, and strong opioid use occurred in 13.0%, 39.1%, and 20.7% of patients, respectively, in the pre-index period versus 12.0%, 34.8%, and 25.0% post-index. Anti-infective, antiemetic, bisphosphonate, glucocorticoid, and G-CSF use occurred in 41.3%, 31.5%, 47.8%, 47.8%, and 0% of patients, respectively, in the pre-index versus 43.5%, 83.7%, 65.2%, 89.1%, and 29.3% post-index. Inpatient admissions, emergency room visits, outpatient services, and prescription use occurred in 13.0%, 23.9%, 100%, and 72.8% of patients, respectively, in the pre-index and in 20.7%, 25.0%, 100%, and 76.1% post-index. Mean total costs were $26,283 pre-index and $61,808 post-index; the main contributor was outpatient services ($20,398 pre-index; $53,536 post-index). Conclusions: In these men with metastatic PC, costs in the 180 day post-taxane CT were two times that seen in the pre-taxane period; outpatient services were the main contributor in both periods.