OBJECTIVES: This study explored patient characteristics, comorbidities, treatment patterns, healthcare resource use (HCRU), and costs using claims data for mUC in Hungary, where access to immunotherapy has been restricted to a named-patient reimbursement program.

METHODS: Anonymized claims from the Hungarian National Health Insurance Fund (NHIFA) database, a single payer covering the population of 10 million inhabitants, were analyzed. The study period was from 1 January 2016 through 30 June 2021, with a 1-year baseline period. Adults with an incident mUC diagnosis at the index date (ICD-10 codes, C65-C68; malignant neoplasms of urinary tract) with evidence of metastatic disease (ICD-10 codes, C77-79) and ≥2 outpatient or ≥1 inpatient claims were included. Results were summarized using descriptive statistics. HCRU and costs were calculated on a per-patient per-year (PPPY) basis and adjusted to the average euros (€) exchange rate from January-May 2022 (€1=370.37 Hungarian forint). Patient characteristics were described at the index date; treatments, HCRU, and costs were described during follow-up.

RESULTS: A total of 2,523 eligible patients with mUC were identified. Mean age was 66.82 years (SD, 8.39; median, 67), and 72.22% were men. Mean Deyo-Charlson Comorbidity Index score was 1.89 (SD, 1.68; median, 2). Median follow-up was 7.13 months. Most patients underwent ≥1 surgical procedures (61.47%) and/or received systemic anticancer therapy (49.78%); radiation therapy was less frequent (2.26%). Patients with mUC had a median of 6 outpatient visits (IQR, 3-11) and 1 hospitalization (IQR, 1-2) PPPY. The median all-cause medical PPPY costs were €1,199.66 (IQR, €433.19-€2,794.78) during follow-up, with drug costs being the primary cost driver (70.33%).

CONCLUSIONS: This analysis describes the real-world clinical management and economic burden of mUC in Hungary in a mainly elderly population of patients with comorbidities. It captures direct measurable healthcare costs only, thereby underestimating the true societal burden of mUC on patients and families.