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Prevalence of bone metastases and bone-targeting agent use among solid tumor patients in the United States.

Hernandez RK, Adhia A, Wade SW, O'Connor E, Arellano J, Francis K, Alvrtsyan H, Million RP, Liede A - Clin Epidemiol (2015)

Bottom Line: Population-based estimates of the prevalence of bone metastases associated with solid tumors, and current treatment patterns for these patients, are limited.There were ~330,000 (168,063 Medicare fee-for-service; 162,239 other) patients aged ≥18 years living with solid tumors and bone metastases in 2012.BTA were used by 43% (Commercial) to 47% (Medicare) of patients in 2012, with the greatest use among breast cancer patients.

View Article: PubMed Central - PubMed

Affiliation: Amgen Inc., Thousand Oaks, CA, USA.

ABSTRACT

Purpose: Patients with bone metastases are at an increased risk of experiencing morbidity due to bone complications, and bone-targeting agents (BTA) are indicated for the prevention of these complications. Population-based estimates of the prevalence of bone metastases associated with solid tumors, and current treatment patterns for these patients, are limited. This study was undertaken to estimate the prevalence of bone metastases from solid tumors and to describe recent trends in the use of BTA in the US.

Methods: We estimated the prevalence of bone metastases in the US in 2012 using data from Medicare fee-for-service and PharMetrics Plus, a large commercial claims database. We evaluated the proportion of patients with bone metastases who were treated with BTA in 2012, timing of initiation of BTA relative to bone metastasis diagnosis, and persistence on BTA, overall and by primary tumor type and treatment.

Results: There were ~330,000 (168,063 Medicare fee-for-service; 162,239 other) patients aged ≥18 years living with solid tumors and bone metastases in 2012. BTA were used by 43% (Commercial) to 47% (Medicare) of patients in 2012, with the greatest use among breast cancer patients. Over half (Medicare: 57%; Commercial: 53%) of BTA-treated patients initiated BTA after experiencing a bone complication.

Conclusion: Of the estimated 330,000 solid tumor patients living with bone metastases in the US in 2012, many may have received less than optimal care to prevent bone complications during the calendar year.

No MeSH data available.


Related in: MedlinePlus

Projection methodology.Abbreviations: FFS, fee-for-service; CMS, Centers for Medicare and Medicaid Services.
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f1-clep-7-335: Projection methodology.Abbreviations: FFS, fee-for-service; CMS, Centers for Medicare and Medicaid Services.

Mentions: From each data source, we determined the number of patients with solid tumor-related bone metastases in 2012 (per definition earlier), and subsequently projected this estimate to the national US level (Figure 1). Unique Medicare patients with bone metastases were identified in the 5% carrier file and the 100% institutional claims file. To estimate the national bone metastasis prevalence for the Medicare cohort, the carrier file was linked to the institutional claims file. Patients identified in both files or in the 100% institutional claims only were counted once; however, the count of patients identified US only in the 5% carrier file was multiplied by 20. For the Commercial national projection, the prevalence of bone metastases were calculated using all patients in the commercial data set as the denominator. We applied this proportion to the entire US population aged 18+ using 2012 census data as the denominator, excluding Medicare FFS beneficiaries using Centers for Medicare and Medicaid Services-reported estimates. Thus, the Medicare projected prevalence represents all patients with bone metastases aged ≥18 years with Medicare FFS, while the Commercial projected prevalence represents all other patients (regardless of insurance status) in the US with bone metastases aged ≥18 years (non-Medicare FFS).


Prevalence of bone metastases and bone-targeting agent use among solid tumor patients in the United States.

Hernandez RK, Adhia A, Wade SW, O'Connor E, Arellano J, Francis K, Alvrtsyan H, Million RP, Liede A - Clin Epidemiol (2015)

Projection methodology.Abbreviations: FFS, fee-for-service; CMS, Centers for Medicare and Medicaid Services.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4514316&req=5

f1-clep-7-335: Projection methodology.Abbreviations: FFS, fee-for-service; CMS, Centers for Medicare and Medicaid Services.
Mentions: From each data source, we determined the number of patients with solid tumor-related bone metastases in 2012 (per definition earlier), and subsequently projected this estimate to the national US level (Figure 1). Unique Medicare patients with bone metastases were identified in the 5% carrier file and the 100% institutional claims file. To estimate the national bone metastasis prevalence for the Medicare cohort, the carrier file was linked to the institutional claims file. Patients identified in both files or in the 100% institutional claims only were counted once; however, the count of patients identified US only in the 5% carrier file was multiplied by 20. For the Commercial national projection, the prevalence of bone metastases were calculated using all patients in the commercial data set as the denominator. We applied this proportion to the entire US population aged 18+ using 2012 census data as the denominator, excluding Medicare FFS beneficiaries using Centers for Medicare and Medicaid Services-reported estimates. Thus, the Medicare projected prevalence represents all patients with bone metastases aged ≥18 years with Medicare FFS, while the Commercial projected prevalence represents all other patients (regardless of insurance status) in the US with bone metastases aged ≥18 years (non-Medicare FFS).

Bottom Line: Population-based estimates of the prevalence of bone metastases associated with solid tumors, and current treatment patterns for these patients, are limited.There were ~330,000 (168,063 Medicare fee-for-service; 162,239 other) patients aged ≥18 years living with solid tumors and bone metastases in 2012.BTA were used by 43% (Commercial) to 47% (Medicare) of patients in 2012, with the greatest use among breast cancer patients.

View Article: PubMed Central - PubMed

Affiliation: Amgen Inc., Thousand Oaks, CA, USA.

ABSTRACT

Purpose: Patients with bone metastases are at an increased risk of experiencing morbidity due to bone complications, and bone-targeting agents (BTA) are indicated for the prevention of these complications. Population-based estimates of the prevalence of bone metastases associated with solid tumors, and current treatment patterns for these patients, are limited. This study was undertaken to estimate the prevalence of bone metastases from solid tumors and to describe recent trends in the use of BTA in the US.

Methods: We estimated the prevalence of bone metastases in the US in 2012 using data from Medicare fee-for-service and PharMetrics Plus, a large commercial claims database. We evaluated the proportion of patients with bone metastases who were treated with BTA in 2012, timing of initiation of BTA relative to bone metastasis diagnosis, and persistence on BTA, overall and by primary tumor type and treatment.

Results: There were ~330,000 (168,063 Medicare fee-for-service; 162,239 other) patients aged ≥18 years living with solid tumors and bone metastases in 2012. BTA were used by 43% (Commercial) to 47% (Medicare) of patients in 2012, with the greatest use among breast cancer patients. Over half (Medicare: 57%; Commercial: 53%) of BTA-treated patients initiated BTA after experiencing a bone complication.

Conclusion: Of the estimated 330,000 solid tumor patients living with bone metastases in the US in 2012, many may have received less than optimal care to prevent bone complications during the calendar year.

No MeSH data available.


Related in: MedlinePlus