POSB53 Healthcare Resource Utilization (HCRU) and Cost Studies in Patients Receiving First-Line (1L) Therapy for Advanced or Metastatic Urothelial Carcinoma (MUC): A Systematic Literature Review (SLR)

This SLR identified studies reporting on costs and HCRU in patients receiving 1L therapy for advanced or mUC. Embase, Medline (In-Process), EconLit, and Centre for Reviews and Dissemination databases and relevant health technology assessment websites were searched on 22 May 2020 with no date limit, using predefined criteria. The International Society of Pharmacoeconomic and Outcomes Research conference proceedings were searched from 2018-2020. All searches were limited to publications in English. Identified publications were screened by two independent reviewers. Among 2,121 publications identified, 26 individual studies reported on costs and HCRU. All studies were published between 1997 and 2019. Median patient age ranged between 61-80 years. The majority of studies were from the United States (n=19); other studies were from Italy (n=3), Canada (n=1), Spain (n=1), Brazil (n=1), and the Netherlands (n=1). The most common study designs were retrospective claims (n=8) and medical record database analyses (n=8). Prospective studies (n=2), a retrospective chart review (n=1), and a simulation model (n=1) were also used to report cost outcomes. Most studies (n=23) researched an advanced/mUC population without investigating the impact of specific treatments on costs and HCRU. Twenty-three publications reported direct healthcare unit costs for physician, outpatient, and emergency department visits; hospitalization; surgery; and examinations; as well as costs of adverse events, drug acquisition and administration, and hospice care. Half of the studies reported HCRU (n=13), including estimated frequencies for diagnostics, surgery, radiation, hospital admissions, and hospital visits. Information on total costs (n=9), either per patient or by population, length of hospital stay (n=4), and work-productivity loss (n=2) was also identified. Most identified studies evaluating 1L treatment of advanced or mUC reported non-treatment specific costs. Further research is needed to understand how these HCRU and cost estimates are affected by emergent therapies.