A Real-World Study of Healthcare Resource Utilization (HCRU) and Associated Healthcare Costs for Patients With Locally Advanced or Metastatic Urothelial Carcinoma (la/mUC) in Taiwan
Author(s)
Li-Nien Chien, PhD1, Chun-Te Wu, PhD2, Louise Young, PhD3, Arthur Lee, PhD4, Meng-Yun Ku, .5, Yi-Chen Hsieh, PhD6, Hung-Wei Lin, MSc7, Kuan-Lin Lin, MSc7, Kai-Pei Chou, MSc7, Mairead Kearney, MB, BCh, MPH, MBA, MSc Econ8.
1Institute of Health and Welfare Policy, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, 2Department of Urology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, 3Global Medical Unit Oncology, Merck Pte. Ltd., an affiliate of Merck KGaA, Singapore, Singapore, 4Medical Affairs, Merck Ltd., an affiliate of Merck KGaA, Taipei, Taiwan, 5Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei, Taiwan, 6Ph.D. Program in Medical Neuroscience, College of Medical Science and Technology Taipei Medical University, Taipei, Taiwan, 7Real-World Solutions, IQVIA Solutions Taiwan, Taipei, Taiwan, 8Global Value Demonstration, Market Access and Pricing, Biopharma, Global Operations, Merck Healthcare KGaA, Darmstadt, Germany.
1Institute of Health and Welfare Policy, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, 2Department of Urology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, 3Global Medical Unit Oncology, Merck Pte. Ltd., an affiliate of Merck KGaA, Singapore, Singapore, 4Medical Affairs, Merck Ltd., an affiliate of Merck KGaA, Taipei, Taiwan, 5Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei, Taiwan, 6Ph.D. Program in Medical Neuroscience, College of Medical Science and Technology Taipei Medical University, Taipei, Taiwan, 7Real-World Solutions, IQVIA Solutions Taiwan, Taipei, Taiwan, 8Global Value Demonstration, Market Access and Pricing, Biopharma, Global Operations, Merck Healthcare KGaA, Darmstadt, Germany.
OBJECTIVES: The study aimed to investigate the HCRU and direct healthcare costs of la/mUC in Taiwan.
METHODS: Adults diagnosed with la/mUC between 2011 and 2020 were identified in the Taiwan Cancer Registry. HCRU and costs were captured from the National Health Insurance Research Database, a claim-based data source. The index date was the date of la/mUC diagnosis, and patients were followed up until death or end of 2021. Outpatient and inpatient visits (with or without intensive care unit [ICU] stay) were analyzed, and records with a diagnosis of UC were defined as UC-related HCRU. Costs are reported in US dollars ($1 US dollar = $30 New Taiwan dollars).
RESULTS: A total of 2,894 patients with la/mUC were identified (median age, 72 years; male, 59.8%). With a total follow-up of 3,940.3 patient-years, the average frequency (SD) of all-cause outpatient and inpatient visits was 53.3 (25.5) and 8.4 (7.5) per patient-year (PPY), respectively. For UC-related HCRU, the mean (SD) visits PPY were 34.2 (18.8) for outpatient, 2.7 (4.6) for inpatient with ICU stay, and 7.1 (6.9) for inpatient without ICU stay. The average length (SD) of stay were 23.9 (20.4) and 7.7 (10.3) days for hospitalization with and without ICU stay, respectively. The total mean (SD) healthcare costs PPY were $32,359.9 ($33,337.8), and the average (SD) UC-related outpatient, hospitalization with ICU, and hospitalization without ICU costs per visit were $6,522.8 ($6,970.0), $23,938.9 ($44,343.5), and $15,589.8 ($18,765.3), respectively.
CONCLUSIONS: This retrospective population-based cohort study is the first to describe the healthcare burden associated with la/mUC in Taiwan from the national payer’s perspective. The main drivers of healthcare cost were hospitalization followed by outpatient care costs. With the introduction of novel and effective systemic anti-cancer treatments, further research is needed to understand if these emerging therapies offer significant savings in HCRU and costs in Taiwan.
METHODS: Adults diagnosed with la/mUC between 2011 and 2020 were identified in the Taiwan Cancer Registry. HCRU and costs were captured from the National Health Insurance Research Database, a claim-based data source. The index date was the date of la/mUC diagnosis, and patients were followed up until death or end of 2021. Outpatient and inpatient visits (with or without intensive care unit [ICU] stay) were analyzed, and records with a diagnosis of UC were defined as UC-related HCRU. Costs are reported in US dollars ($1 US dollar = $30 New Taiwan dollars).
RESULTS: A total of 2,894 patients with la/mUC were identified (median age, 72 years; male, 59.8%). With a total follow-up of 3,940.3 patient-years, the average frequency (SD) of all-cause outpatient and inpatient visits was 53.3 (25.5) and 8.4 (7.5) per patient-year (PPY), respectively. For UC-related HCRU, the mean (SD) visits PPY were 34.2 (18.8) for outpatient, 2.7 (4.6) for inpatient with ICU stay, and 7.1 (6.9) for inpatient without ICU stay. The average length (SD) of stay were 23.9 (20.4) and 7.7 (10.3) days for hospitalization with and without ICU stay, respectively. The total mean (SD) healthcare costs PPY were $32,359.9 ($33,337.8), and the average (SD) UC-related outpatient, hospitalization with ICU, and hospitalization without ICU costs per visit were $6,522.8 ($6,970.0), $23,938.9 ($44,343.5), and $15,589.8 ($18,765.3), respectively.
CONCLUSIONS: This retrospective population-based cohort study is the first to describe the healthcare burden associated with la/mUC in Taiwan from the national payer’s perspective. The main drivers of healthcare cost were hospitalization followed by outpatient care costs. With the introduction of novel and effective systemic anti-cancer treatments, further research is needed to understand if these emerging therapies offer significant savings in HCRU and costs in Taiwan.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE29
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Oncology, Urinary/Kidney Disorders