The economic burden of metastatic castration-resistant prostate cancer: U.S. Medicare perspective.
Bibliographic record
Abstract
e16025 Background: Castration-resistant metastatic prostate cancer (mCRPC) is associated with high medical costs and resource utilization. The aim of this study was to examine the total direct medical costs and resource utilization of mCRPC patients covered by Medicare. Methods: A retrospective analysis was performed using a representative 5% sample of 1999-2010 quarterly Medicare claims. Males over the age of 18 were included in the analysis if they had all of the following: (i) at least one claim with a diagnosis of prostate cancer, (ii) at least one claim for a mCRPC treatment between January 1, 1999 and December 31, 2010, (iii) a diagnosis of bone metastases after their prostate cancer diagnosis but before receiving mCRPC treatment, (iv) at least one quarter of Medicare eligibility before and after their index quarter, which was defined as the quarter of bone metastases diagnosis. Descriptive summary statistics of patient healthcare resource utilization and medical costs were reported on a per patient per quarter (PPPQ) basis. Results: A total of 5,018 mCRPC patients were identified from 1999-2010 with a mean (SD) age at index of approximately 76 (7) years and an average follow up time of 2.0 years. During the index quarter, mCRPC patients had a mean (SD) of 29.2 (19.1) medical claims for a mean (SD) cost of $13,649 ($15,943). Post index, the average number of claims per patient was higher than pre-index (20.0 vs. 9.8) resulting in substantially higher costs ($9,512 vs. $3,220). MCRPC patients received more frequent medical scanning during and after index, with patients receiving 3.2 scans during the index quarter and 1.2 scans PPPQ post-index compared to 0.6 scans PPPQ pre-index. PSA testing increased from 0.6 tests PPPQ before the index quarter to 1.4 tests PPPQ from the index quarter onwards. Conclusions: Based on data from the Medicare database from the decade prior to the approval of sipuleucel-T, cabazitaxel, abiraterone, and enzalutamide , the cost of care of patients with mCRPC was approximately $76,000 over 2 years. However, since the Medicare database does not include outpatient prescription data, the actual cost over 2 years is an underestimate. Future costs are expected to rise with the availability of these new agents.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".