Health resource utilization and costs for stage IV bladder cancer in community oncology settings.

e16032 Background: Current real-world data on patients with metastatic bladder cancer in the community setting are limited. This study describes patient characteristics, health resource utilization (HRU), and costs for this population. Methods: Medical records data from adults diagnosed with stage IV bladder cancer (T4b, node-positive, or distant metastatic disease) between 1/1/2008 and 6/1/2015 were retrospectively collected from a network of 10 US community oncology practices. Patient characteristics, HRU, and costs were assessed. Regression models were used to estimate group effects on utilization and costs through three progression-based lines. Results: Of 508 patients, 75% were male, 79% white, 15% African American, and 71.5% were aged ≥65 years (median age, 71 years; range 35-92 years). Overall, 76.4% were current or past tobacco users. The most prevalent comorbidities were diabetes (23.4%), renal disease (16.5%), and chronic obstructive pulmonary disease (COPD; 12.4%). Overall, 70.1% had distant metastases at diagnosis, including bone (24.0%), lung (23.4%), and liver (14.6%). Of 341 patients analyzed for HRU and cost, 58.9% had hospital visits and 11.7% had emergency department (ED) visits. Age, smoking history, and presence of diabetes were predictors of hospitalization (all P< 0.05). Overall mean monthly total healthcare cost was $18,778 ± $47,006 (median $6285), which was driven by hospitalizations ($14,660 ± 44,686, median $1717). Mean monthly ED cost was $776 ± $5530, median $0. Mean monthly cost for office visits was $186 ± $189, median $152. Procedures in the medical oncology setting had a mean monthly cost of $707 ± $1179, median $395. Other costs included systemic therapy ($267 ± $704, median $117), infused supportive care drugs ($758 ± $1458, median $0), and other drugs ($1422 ± $3745, median $136). Age, presence of diabetes, presence of any comorbidities, body mass index, and impaired composite performance status were predictors of healthcare costs (all P< 0.05). Conclusions: This study showed significant HRU and costs for metastatic bladder cancer patients suggesting high unmet need.