OBJECTIVES: Compare health care resource utilization and costs of patients with and without bladder cancer (BC) in the US Department of Defense (DoD) population.

METHODS: A retrospective study was performed using 100% DoD data from 01OCT2011-30SEPT2016. Adult patients diagnosed with ≥1 claim for BC were identified using International Classification of Diseases, 9^th/10^th Revision, Clinical Modification (ICD-9/10-CM) diagnosis codes (ICD-9-CM: 188; ICD-10-CM: C67). The first diagnosis date was designated as the index date. A comparator cohort of patients without a BC diagnosis was created including patients of the same age, sex, race, index year, and similar Charlson comorbidity index (CCI) score. A random index date was chosen for the comparison cohort to reduce selection bias. Patients were required to have continuous medical and pharmacy benefits for 12 months pre- and post-index date. The generalized linear model (GLM) was used to compare follow-up health care resource use and costs between the cohorts, adjusting for clinical characteristics.

RESULTS: A total of 1489 patients were included in each cohort (BC and comparator cohorts). The mean age was 64.2 years, and 74% were men. BC patients had higher CCI scores (1.31 vs 1.18; p<0.0178). After adjusting for clinical characteristics in the GLM model, BC patients had a higher number of health care visits, including inpatient (0.50 vs 0.17; p<0.001), emergency room (0.87 vs 0.50; p<0.001), ambulatory (35.41 vs 20.86, p<0.001), and pharmacy visits (19.30 vs 14.55, p<0.001), as well as longer hospital length of stay (3.39 vs 1.13 days; p<0.001) versus comparator patients. BC patients also incurred higher inpatient ($7,851 vs $2,165; p<0.001), ER ($676 vs $368; p<0.001), ambulatory ($15,700 vs $5,840; p<0.001), and total ($25,537 vs $9,454; p<0.001) health care costs.

CONCLUSIONS: DoD beneficiaries diagnosed with BC incurred higher health care resource utilization and costs relative to those who were not diagnosed with BC.