1372P - Health resource utilisation (HRU) in Europe associated with skeletal-related events (SREs): results from a retrospective study

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Bioethics, Legal, and Economic Issues
Presenter Jean-Jacques Body
Authors J. Body1, J. Pereira2, H. Sleeboom3, N. Maniadakis4, E. Terpos5, J. Finek6, O. Günther7, G. Hechmati8, T. Mossman9, R. von Moos10
  • 1Medicine, Centre Hospitalier Universitaire BrugmannUniversit, BE-1020 - Brussels/BE
  • 2National School Of Public Health, Universidade NOVA de Lisboa, Lisbon/PT
  • 3Department Of General Internal Medicine, HAGA Hospital, The Hague/NL
  • 4Department Of Health Services Management,, National School of Public Health, Athens/GR
  • 5Department Of Clinical Therapeutics, University of Athens School of Medicine, Alexandra University Hospital, Athens/GR
  • 6Comprehensive Cancer Department, University Hospital, Plzen/CZ
  • 77centre For Observational Research, Amgen Ltd., Uxbridge/UK
  • 8Health Economics, Amgen (Europe) GmbH, Zug/CH
  • 9Biostatistics, Contractor Amgen Ltd., Cambridge/UK
  • 10Medizinische Onkologie Und Hämatologie, Cantonal Hospital Graub, CH-7000 - Chur/CH



To evaluate European HRU associated with SREs (radiation to bone [RB], surgery to bone [SB], pathologic fracture [PF], spinal cord compression [SCC]).


Eligible patients (bone metastases from breast/lung/prostate cancer or multiple myeloma, with an index SRE [defined as an SRE preceded by an SRE-free period of at least 6.5 months] between July 2004 and July 2009) were enrolled from Austria, Czech Republic, Finland, Greece, Poland, Portugal, Sweden and Switzerland (Study:20090146). HRU data were gathered from baseline (pre-index SRE period: 3-month period, beginning 3.5 months pre-index SRE) and post-index SRE period (14-day diagnosis period pre-index SRE to 3 months post-SRE). We present mean (bootstrapped 95% confidence interval [CI]) change in HRU from baseline per index SRE for pooled country data.


The Table presents the mean change from baseline in HRU per index SRE for the pooled data from the 8 European countries included in this study. An increase was observed in all HRU types following the index SRE. Change in overall HRU was predominantly driven by increases in the duration of inpatient stays, with a mean increase of between 7.81 and 22.21 days depending on SRE type. Substantial increases were also seen in the number of procedures and the number of outpatient visits, with mean increases from 5.85 to 9.58 and from 2.58 to 4.24, respectively. Of the index SREs, SCC was associated with the greatest increase in HRU burden for the following HRU types: duration of inpatient stays, emergency room (ER) visits, and procedures.


Overall, SREs are associated with substantial HRU burden. The largest increases in HRU burden were seen following SCC.

Mean (95% CI) change from baseline in HRU according to index SRE type (full analysis set).

HRU type RB n = 482 SB n = 99 PF – long bonen = 118 PF – othern = 241 SCC n = 82
Inpatient stays 0.52(0.41, 0.62) 1.48(1.24, 1.72) 1.23(1.02, 1.44) 0.80(0.65, 0.95) 1.33(1.01, 1.65)
Duration of inpatient stays 7.81(6.53, 9.09) 18.81(15.31, 22.31) 20.92(16.90, 24.94) 12.27(9.71, 14.84) 22.21(16.88, 27.54)
Outpatient visits 4.24(3.67, 4.80) 2.65(1.52, 3.78) 2.58(1.70, 3.46) 3.96(3.22, 4.71) 4.06(2.65, 5.47)
ER visits 0.10(0.03, 0.17) 0.18(0.03, 0.33) 0.30(0.17, 0.42) 0.22(0.12, 0.33) 0.45(0.27, 0.64)
Procedures 8.51(7.84, 9.18) 6.36(4.83, 7.90) 6.10(4.80, 7.40) 5.85(5.03, 6.67) 9.58(7.82, 11.35)


J. Body: Consultant for Amgen, Bayer, Novartis. Lectures for Amgen and Novartis.

J. Pereira: Honorarium from Amgen.

H. Sleeboom: Ad Board Novartis and Amgen, speaking honoraria Amgen.

N. Maniadakis: Received honoraria and corporate sponsored research from Amgen Hellas.

E. Terpos: Honorarium from Amgen.

J. Finek: Consultant for GSK, Amgen, Bayer, Novartis and Roche. Lectures for Amgen, Novartis, Roche and Pfizer.

O. Gunther: Employee of Amgen, holds Amgen stock.

G. Hechmati: Employee of Amgen and holds Amgen stock.

T. Mossman: Contractor of Amgen.

R. von Moos: Receive research grants and speaker honoraria from Amgen and Roche. Participate in Ad Boards for Amgen, Roche and Novartis