HEALTHCARE RESOURCE UTILIZATION (HCRU) AND ASSOCIATED ECONOMIC BURDEN OF METASTATIC UROTHELIAL CANCER (MUC) IN FRANCE USING THE SYSTEME NATIONAL DES DONNEES DE SANTE (SNDS) DATABASE: A RETROSPECTIVE COHORT STUDY
Author(s)
Philippe Barthélémy, MD1, Mairead M. Kearney, MBA, MPH, MSc, MD2, Laura Luciani, PharmD, MSc3, Benoit Van Hille, PhD3, Laurent Paret, PhD3, Makan Rahshenas, MD, MSc4, Fayssoil Fouad, Masters4, Vanessa Rascon Velasco, MPH4, Isabelle Durand-Zaleski, MPP, PhD, MD5, Constance Thibault, Masters6.
1Medical Oncology Department, University Hospital - Strasbourg, Strasbourg, France, 2Merck Healthcare KGaA, Darmstadt, Germany, 3Merck Santé S.A.S., an affiliate of Merck KGaA, Lyon, France, 4Oracle, Paris, France, 5Université de Paris, CRESS, AP-HP, Paris, France, 6Department of Medical Oncology, Hôpital Européen Georges-Pompidou, Institut du Cancer Paris CARPEM, AP-HP Centre, Université de Paris Cité,, Paris, France.
1Medical Oncology Department, University Hospital - Strasbourg, Strasbourg, France, 2Merck Healthcare KGaA, Darmstadt, Germany, 3Merck Santé S.A.S., an affiliate of Merck KGaA, Lyon, France, 4Oracle, Paris, France, 5Université de Paris, CRESS, AP-HP, Paris, France, 6Department of Medical Oncology, Hôpital Européen Georges-Pompidou, Institut du Cancer Paris CARPEM, AP-HP Centre, Université de Paris Cité,, Paris, France.
OBJECTIVES: Real-world data on HCRU and costs for patients with mUC in France are limited. The aim of this retrospective, nationwide study was to quantify the economic burden of mUC.
METHODS: This descriptive, retrospective cohort study using claims data from the SNDS included adult patients diagnosed with mUC between 1 January 2017 and 31 December 2023. HCRU included hospitalizations, drugs, consultations, outpatient procedures, imaging and laboratory tests, medical devices, transportation, sick leaves, and disability benefits. Patient characteristics were described at index date (mUC diagnosis), while treatments, HCRU, and costs were assessed during follow-up.
RESULTS: In total, 27,762 patients with mUC were included. Most were male (77.9%), with a median age of 75 years and a median Charlson Comorbidity Index score of 4. Median follow-up was 3 months, with an 88.1% mortality rate. Almost all patients (99.9%) were hospitalized, while 73.2% had at least 1 physician visit and 71.8% received at least 1 dispensed medication. Total all-cause healthcare costs during follow-up were €1.41B, equivalent to €5,088 per patient-month; hospitalizations accounted for €663.7M (47.2%), including €568.1M (85.6%) in medical-surgical care, €38.9M (5.9%) in hospital-at-home care, and €56.7M (8.5%) in rehabilitative care. Medications accounted for €529.1M (37.6%). All-cause procedures, imaging, laboratory tests, medical devices, transportation, sick leaves, and disability benefits contributed €158.1M (11.2%) to total costs. Overall, 69% of costs were accrued during the first year after mUC diagnosis, with €525.0M (54.2%) attributable to hospitalizations and €305.0M (31.5%) to medications.
CONCLUSIONS: This population-based study demonstrates the high economic burden of mUC on the healthcare system in France. The key drivers of healthcare costs were hospitalization followed by medication. The highest costs were incurred during the first year following mUC diagnosis, mainly driven by hospitalization. As the treatment landscape evolves, further research is needed to understand how the currently approved novel therapies affect these HCRU and cost estimates.
METHODS: This descriptive, retrospective cohort study using claims data from the SNDS included adult patients diagnosed with mUC between 1 January 2017 and 31 December 2023. HCRU included hospitalizations, drugs, consultations, outpatient procedures, imaging and laboratory tests, medical devices, transportation, sick leaves, and disability benefits. Patient characteristics were described at index date (mUC diagnosis), while treatments, HCRU, and costs were assessed during follow-up.
RESULTS: In total, 27,762 patients with mUC were included. Most were male (77.9%), with a median age of 75 years and a median Charlson Comorbidity Index score of 4. Median follow-up was 3 months, with an 88.1% mortality rate. Almost all patients (99.9%) were hospitalized, while 73.2% had at least 1 physician visit and 71.8% received at least 1 dispensed medication. Total all-cause healthcare costs during follow-up were €1.41B, equivalent to €5,088 per patient-month; hospitalizations accounted for €663.7M (47.2%), including €568.1M (85.6%) in medical-surgical care, €38.9M (5.9%) in hospital-at-home care, and €56.7M (8.5%) in rehabilitative care. Medications accounted for €529.1M (37.6%). All-cause procedures, imaging, laboratory tests, medical devices, transportation, sick leaves, and disability benefits contributed €158.1M (11.2%) to total costs. Overall, 69% of costs were accrued during the first year after mUC diagnosis, with €525.0M (54.2%) attributable to hospitalizations and €305.0M (31.5%) to medications.
CONCLUSIONS: This population-based study demonstrates the high economic burden of mUC on the healthcare system in France. The key drivers of healthcare costs were hospitalization followed by medication. The highest costs were incurred during the first year following mUC diagnosis, mainly driven by hospitalization. As the treatment landscape evolves, further research is needed to understand how the currently approved novel therapies affect these HCRU and cost estimates.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE85
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology