HEALTHCARE RESOURCE UTILIZATION (HCRU) AND COSTS OF LOCALLY ADVANCED OR METASTATIC UROTHELIAL CARCINOMA (LA/MUC) IN SWEDEN: A NATIONAL REGISTRY STUDY COMPARING PATIENTS WITH MATCHED POPULATION CONTROLS
Author(s)
Markus Aly, MD, PhD1, Jakob Börsum, MSc2, Fraence Hardtstock, MSc3, Suzanne Bergman, MSc4, Petra Skare, PhD4, Mairead M. Kearney, MB, BCh, MPH, MBA, MSc Econ5.
1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden, 2Cytel Inc., Stockholm, Sweden, 3Cytel Inc., Berlin, Germany, 4Merck AB, an affiliate of Merck KGaA, Solna, Sweden, 5Merck Healthcare KGaA, Darmstadt, Germany.
1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden, 2Cytel Inc., Stockholm, Sweden, 3Cytel Inc., Berlin, Germany, 4Merck AB, an affiliate of Merck KGaA, Solna, Sweden, 5Merck Healthcare KGaA, Darmstadt, Germany.
OBJECTIVES: Evidence describing the economic burden of la/mUC in Sweden is limited. This study aimed to fill that knowledge gap and provide a reference for clinicians and policymakers to optimize la/mUC management by quantifying its HCRU and direct medical costs compared with a matched population of healthy controls.
METHODS: This retrospective longitudinal case-control study used linked pseudonymized Swedish national registers. Patients with incident la/mUC (2006-2021) were identified from the National Cancer Register and matched to controls without UC by age, sex, and region of residence. HCRU included inpatient admissions and duration, outpatient visits, and pharmacy-dispensed medicines. Direct mean medical costs (diagnosis-related group-based care and prescriptions) were reported per patient per year (PPPY; 2021 EUR) during follow-up; cost analyses were restricted to patients indexed from 2012 onward.
RESULTS: The study included 2,026 patients with la/mUC and 10,125 matched controls for HCRU analyses and 1,438 patients with la/mUC and 7,185 matched controls for cost analyses. Compared with matched controls, patients with la/mUC had significantly greater HCRU across all measures (all p<0.001), including inpatient admissions (8.2 vs 0.6 PPPY), hospital stay duration (59.6 vs 3.7 days PPPY), outpatient visits (15.6 vs 2.6 PPPY), and pharmacy-dispensed medicines (62.1 vs 40.9 PPPY). Mean total direct medical costs were approximately 10-fold higher in patients with la/mUC vs matched controls (€49,393 vs €4,621 PPPY). Inpatient care represented the largest contributor to total costs (€41,289 vs €2,956 PPPY), followed by outpatient care (€6,343 vs €863 PPPY) and prescribed medicines (€1,762 vs €801 PPPY).
CONCLUSIONS: This nationwide study is the first to characterize the substantial financial burden of la/mUC incurred by the Swedish public healthcare system, where 83.6% of total costs are attributed to inpatient care. In light of the evolving la/mUC landscape, future research should evaluate how the adoption of novel therapeutic agents impacts the economic burden at a population level.
METHODS: This retrospective longitudinal case-control study used linked pseudonymized Swedish national registers. Patients with incident la/mUC (2006-2021) were identified from the National Cancer Register and matched to controls without UC by age, sex, and region of residence. HCRU included inpatient admissions and duration, outpatient visits, and pharmacy-dispensed medicines. Direct mean medical costs (diagnosis-related group-based care and prescriptions) were reported per patient per year (PPPY; 2021 EUR) during follow-up; cost analyses were restricted to patients indexed from 2012 onward.
RESULTS: The study included 2,026 patients with la/mUC and 10,125 matched controls for HCRU analyses and 1,438 patients with la/mUC and 7,185 matched controls for cost analyses. Compared with matched controls, patients with la/mUC had significantly greater HCRU across all measures (all p<0.001), including inpatient admissions (8.2 vs 0.6 PPPY), hospital stay duration (59.6 vs 3.7 days PPPY), outpatient visits (15.6 vs 2.6 PPPY), and pharmacy-dispensed medicines (62.1 vs 40.9 PPPY). Mean total direct medical costs were approximately 10-fold higher in patients with la/mUC vs matched controls (€49,393 vs €4,621 PPPY). Inpatient care represented the largest contributor to total costs (€41,289 vs €2,956 PPPY), followed by outpatient care (€6,343 vs €863 PPPY) and prescribed medicines (€1,762 vs €801 PPPY).
CONCLUSIONS: This nationwide study is the first to characterize the substantial financial burden of la/mUC incurred by the Swedish public healthcare system, where 83.6% of total costs are attributed to inpatient care. In light of the evolving la/mUC landscape, future research should evaluate how the adoption of novel therapeutic agents impacts the economic burden at a population level.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE692
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology