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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

Twelve-month persistence with BTA.Notes: (A) All Medicare patients, (B) all Commercial patients, (C) Medicare patients excluding the patients who died in 2012, and (D) Commercial patients excluding the patients who died in 2012.Abbreviation: BTA, bone-targeting agent.
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f3-clep-7-335: Twelve-month persistence with BTA.Notes: (A) All Medicare patients, (B) all Commercial patients, (C) Medicare patients excluding the patients who died in 2012, and (D) Commercial patients excluding the patients who died in 2012.Abbreviation: BTA, bone-targeting agent.

Mentions: Persistence with therapy was assessed for 2,585 Medicare and 7,312 Commercial BTA users who initiated therapy on or after January 1, 2011. Persistence was similar for Medicare and Commercial patients; 63%–64% of patients persisted on BTA therapy at 6 months post-initiation and ~50% of patients persisted at 12 months post-initiation (Figure 3). After excluding the patients who died in 2012, the 6- and 12-month probabilities of persistence were slightly higher (66%–69% and 53%–58%, respectively). Further analysis indicated that persistence varied by agent. Patients treated with denosumab had substantially higher persistence levels at 12 months (Medicare: 58%; Commercial: 57%) compared with both zoledronic acid (Medicare: 37%; Commercial: 36%) and pamidronate (Medicare: 37%; Commercial: 38%), although results for pamidronate should be interpreted with caution, given the small sample sizes.


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)

Twelve-month persistence with BTA.Notes: (A) All Medicare patients, (B) all Commercial patients, (C) Medicare patients excluding the patients who died in 2012, and (D) Commercial patients excluding the patients who died in 2012.Abbreviation: BTA, bone-targeting agent.
© Copyright Policy
Related In: Results  -  Collection

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

f3-clep-7-335: Twelve-month persistence with BTA.Notes: (A) All Medicare patients, (B) all Commercial patients, (C) Medicare patients excluding the patients who died in 2012, and (D) Commercial patients excluding the patients who died in 2012.Abbreviation: BTA, bone-targeting agent.
Mentions: Persistence with therapy was assessed for 2,585 Medicare and 7,312 Commercial BTA users who initiated therapy on or after January 1, 2011. Persistence was similar for Medicare and Commercial patients; 63%–64% of patients persisted on BTA therapy at 6 months post-initiation and ~50% of patients persisted at 12 months post-initiation (Figure 3). After excluding the patients who died in 2012, the 6- and 12-month probabilities of persistence were slightly higher (66%–69% and 53%–58%, respectively). Further analysis indicated that persistence varied by agent. Patients treated with denosumab had substantially higher persistence levels at 12 months (Medicare: 58%; Commercial: 57%) compared with both zoledronic acid (Medicare: 37%; Commercial: 36%) and pamidronate (Medicare: 37%; Commercial: 38%), although results for pamidronate should be interpreted with caution, given the small sample sizes.

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