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An assessment of the direct and indirect costs of bladder cancer preceding and following a cystectomy: a real-world evidence study.
An assessment of the direct and indirect costs of bladder cancer preceding and following a cystectomy: a real-world evidence study. Journal of medical economics Tkacz, J., Ireland, A., Agatep, B., Ellis, L., Balaji, H., Khaki, A. R. 2024: 1-14Abstract
Introduction: To estimate the direct and indirect costs of bladder cancer prior to and following cystectomy in a U.S. sample of patients.Methods: This retrospective, observational analysis of de-identified patients with bladder cancer utilized the MarketScan Commercial Claims & Encounters and Health & Productivity Management databases. Adult patients with bladder cancer plus = 1 claim for partial or radical cystectomy between 10/1/2015 - 12/31/20 (date of the cystectomy=index date) and who were continuously enrolled for 6 months pre- (baseline) and post-index (follow-up) were included in the sample. All-cause total healthcare costs and indirect costs associated with short-term and long-term disability (STD and LTD) employer claims were assessed during each of the 6-month baseline and follow-up periods.Results: The study included N=142 patients; mean age 56±6 years, 76% (male), and 42% had a baseline Deyo-Charlson Comorbidity Index = 2. Baseline mean total all-cause direct healthcare costs were $51,473 ± $48,560 (median: $36,202), and $99,524±86,839 (median: $75,444) during follow-up. At baseline, 32% of patients had = 1 STD claim, equating to a mean 134±303hours lost and $2,353 ± $6,445 in total payments per patient. Follow up STD claims increased 23.4% equating to a mean 218±324hours lost and $3,679 ± $7,795 per patient. Patient LTD claims increased from baseline to follow-up (1% to 3%), with post-cystectomy LTD claims resulting in 574±490hours lost, and $1,636 ± $1,429 in total payments. Over 85% of the population had a cystectomy related complication, the most common were genitourinary-related (47.9%) and infection/sepsis (33.1%).Conclusions: Cystectomy was associated with complications and decreased work productivity post-surgery. Findings may aid to inform decisions regarding cystectomy vs. bladder preservation approaches, and underscores an ongoing need to further develop bladder preservation therapies within the bladder cancer treatment landscape.
View details for DOI 10.1080/13696998.2024.2382639
View details for PubMedID 39028539