Hospital resource utilization and treatment cost of skeletal-related events in patients with metastatic breast or prostate cancer: Estimation for the Portuguese national health system

Background: Skeletal-related events (SREs) occur frequently in patients with bone metastases as a result of breast (BC) and prostate (PC) cancers. They increase both morbidity and mortality and lead to extensive health-care resource utilization. Methods: Health care resource utilization by BC/PC patients with at least one SRE during the preceding 12 months was assessed through retrospective chart review. SRE-treatment costs were estimated using the Portuguese Ministry of Health cost database and analyzed using generalized linear models. Results: This study included 152 patients from nine hospitals. The mean (SD) annual SRE-treatment cost per patient was ε5963 (ε3646) and ε5711 (ε4347), for BC (n=121) and PC (n=31) patients, respectively. Mean cost per single episode ranged between ε1485 (radiotherapy) and ε13,203 (spinal cord compression). Early onset of bone metastasis (P = 0.03) and diagnosis of bone metastases at or after the occurrence of the first SRE (P = 0.001) were associated with higher SRE-treatment costs. Conclusion: These results reveal the high hospital SRE-treatment costs, highlighting the need for early diagnosis and treatment, and identify key factors determining the economic value of therapies for patients with skeletal metastases.