TRENDS IN 12-MONTH MORTALITY AND STATUTORY HEALTH INSURANCE COSTS IN INCIDENT METASTATIC BLADDER CANCER IN GERMANY, 2011-2024
Author(s)
Antje Mevius, MA1, Barthold Deiters, Dr.2, Sabrina Müller, MSc3, Stefano Tagliabue, MSc3, Thomas Wilke, PhD1, Benjamin Birkner, Dr.4.
1IPAM e.V., Wismar, Germany, 2GWQ ServicePlus AG, Düsseldorf, Germany, 3GIPAM GmbH, Wismar, Germany, 4GWQ ServicePlus AG, Hamburg, Germany.
1IPAM e.V., Wismar, Germany, 2GWQ ServicePlus AG, Düsseldorf, Germany, 3GIPAM GmbH, Wismar, Germany, 4GWQ ServicePlus AG, Hamburg, Germany.
OBJECTIVES: To describe trends in age- and sex-standardized 12-month overall survival (OS) and inflation-adjusted costs among patients with incident metastatic bladder cancer (mBLC) in anonymized German statutory health insurance claims data from 2011 to 2024.
METHODS: Patients with mBLC were identified using ICD-10-GM diagnosis codes: C67 (BLC) and C77-C79 for metastatic disease. Metastatic disease was required to occur within ±3 months of the qualifying BLC diagnosis, with no evidence of mBLC during a 1-year baseline period. Age- and sex-standardized 12-month OS, standardized to the overall German statutory health insurance population, was assessed from the date of incident mBLC (index date). Fourteen annual cohorts were defined according to index year of each patient (2011-2024). Inflation-adjusted all-cause healthcare costs were measured over the 12-month post-index period for each patient and reported by index-year cohort. Trends in OS and costs were evaluated over time, using 2011 as the reference year.
RESULTS: Annual cohorts were small, with 52 patients in 2011 (mean age: 69.5 years; 15.4% females), a peak of 195 in 2020 (mean age: 69.4 years; 23.6% females), and 56 patients (mean age: 73.0 years; 19.6% females) in 2024. Standardized 12-month OS varied substantially, from 82.4% in patients diagnosed in 2011 to only 62.7% in patients diagnosed in 2020. Over the 14 years, no OS improvement was observed, in 2024 12-month OS was 70.8%. Costs increased from €32,245 to €43,042 per patient, with a more pronounced rise during the most recent five years and a peak of €49,500 in 2023. Costs excluding the final 4 weeks before death increased from €30,367 to €37,664. Cost shares remained broadly similar over time, with inpatient care continuing to represent the most important cost component.
CONCLUSIONS: In incident metastatic bladder cancer, rising costs were not accompanied by improved standardized 12-month OS. Interpretation should consider small annual sample sizes and year-to-year variability.
METHODS: Patients with mBLC were identified using ICD-10-GM diagnosis codes: C67 (BLC) and C77-C79 for metastatic disease. Metastatic disease was required to occur within ±3 months of the qualifying BLC diagnosis, with no evidence of mBLC during a 1-year baseline period. Age- and sex-standardized 12-month OS, standardized to the overall German statutory health insurance population, was assessed from the date of incident mBLC (index date). Fourteen annual cohorts were defined according to index year of each patient (2011-2024). Inflation-adjusted all-cause healthcare costs were measured over the 12-month post-index period for each patient and reported by index-year cohort. Trends in OS and costs were evaluated over time, using 2011 as the reference year.
RESULTS: Annual cohorts were small, with 52 patients in 2011 (mean age: 69.5 years; 15.4% females), a peak of 195 in 2020 (mean age: 69.4 years; 23.6% females), and 56 patients (mean age: 73.0 years; 19.6% females) in 2024. Standardized 12-month OS varied substantially, from 82.4% in patients diagnosed in 2011 to only 62.7% in patients diagnosed in 2020. Over the 14 years, no OS improvement was observed, in 2024 12-month OS was 70.8%. Costs increased from €32,245 to €43,042 per patient, with a more pronounced rise during the most recent five years and a peak of €49,500 in 2023. Costs excluding the final 4 weeks before death increased from €30,367 to €37,664. Cost shares remained broadly similar over time, with inpatient care continuing to represent the most important cost component.
CONCLUSIONS: In incident metastatic bladder cancer, rising costs were not accompanied by improved standardized 12-month OS. Interpretation should consider small annual sample sizes and year-to-year variability.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE543
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Oncology