Objectives
To evaluate the healthcare resources’ consumption and integrated costs in the perspective of the Italian National Health System (NHS) of patients with renal cell carcinoma and incident metastasis (mRCC).
Methods
Starting from the ReS database, through the NHS administrative data record linkage, patients aged ≥18 and hospitalized (ICD9-CM code) with primary/secondary diagnosis of renal cancer and lymph node and/or distant metastases in the same discharge form (index date) were selected in 2015 (accrual period). The incidence of metastases was ascertained by their absence in two years before the index date. The cohort was characterized in the accrual by gender, age and comorbidities of interest. Daily and ordinary hospitalizations, outpatient specialist care and integrated NHS healthcare expenditure (from the sum of pharmaceuticals, hospitalizations, outpatient services' cost) were analysed during the one-year follow-up. Costs in charge to the NHS must be ascribed to patients’ demographics and comorbidities, other than the neoplastic care.
Results
Out of >7 million inhabitants of the ReS database in 2015, 133 adults (2.1x100,000) were hospitalized with a diagnosis of mRCC. The 63.2% of them (1.4x100,000) received a new diagnosis of metastasis in 2015 (73.8% males, mean age [±SD] 68±13). The most common comorbidity was arterial hypertension (70.2% of the incident cohort). During the one-year follow-up, >90% of patients were hospitalized, mostly ascribed to kidney cancer, metastasis and antineoplastic therapy. On average, hospitalizations costed €8,897/patient: 6.1% of the expenditure in daily and 11.4% in ordinary regimen were ascribed to antineoplastic therapy. The 82.1% entrusted the outpatient specialist care accounting for €1,075/patient (26.9% for antineoplastic therapy). The mean total healthcare expenditure for the NHS was €22,067/patient.
Conclusions
This study shows the current burden of mRCC in Italy. Real-world findings can reveal the real impact of mRCC, estimate the target population of incoming first line therapies and help responding to unmet clinical needs.
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