Copyright © 2014 Published by Elsevier Inc.Objectives: This study estimates the impact of Non-Small Cell Lung Cancer (NSCLC) on population health levels and its economic impact in Portugal in 2012.info:eu-repo/semantics/publishedVersio

Alarcão, Joana

Barata, F.

Borges, Margarida

Carneiro, António Vaz

Costa, João

Gouveia, Miguel

Laranjeira, E.

Lopes, F.

Parente, B.

Pinheiro, L.

Sousa, Rita

Teixeira, E.

Value in Health

English

Borges, M.

Gouveia, M.

Alarcão, J.

Sousa, R.

Vaz-Carneiro, A.

Costa, J.

Elsevier - Publisher Connector 

PCN70 Cost and Burden of Non-Small Cell Lung Cancer's in Portugal 

M. Borges

M. Gouveia

J. Alarcão

R. Sousa

E. Teixeira

F. Barata

E. Laranjeira

F. Lopes

B. Parente

L. Pinheiro

A. Vaz-Carneiro

J. Costa

Crossref

Cost and Burden of Non-Small Cell Lung Cancer's in Portugal

Universidade de Lisboa: Repositório.UL

A626  VA L U E  I N  H E A LT H  1 7  ( 2 0 1 4 )  A 3 2 3 – A 6 8 6  2039 to EUR 9346, depending on care required, more costly than SREs without hospi-talization (n= 165). These SREs had median costs of EUR 200 to EUR 1912, depending on care required. ConClusions: The impact of SREs on total costs could justify policy aimed at actively preventing SREs, e.g. with radionuclide therapy, possibly resulting in better quality of life and cost-reduction. Treatment of prostate cancer with bone metastases is not very costly compared to lung-and breast cancer with similar metastases. However, novel therapeutic options may dramatically increase treatment costs in the near future and proper head-to-head cost-effectiveness stud-ies of all treatment modalities are therefore necessary.PCN72ECoNomiC imPaCt modEl of BrEast CaNCEr trEatmENt at Early stagEs iN thE mExiCaN PuBliC hEalth CarE sECtorGuirant-Corpi L.1, Hernandez-Reyes F.C.1, Kelly J.2, Muciño-Ortega E.11Pfizer S.A. de C.V., Ciudad de México, Mexico, 2Centro Médico Nacional Siglo XXI, Mexico City, MexicoobjeCtives: Nowadays breast cancer represents a great economic burden to public health care sector in Mexico. This economic burden is due by a lack of prevention campaigns and late diagnosis. The analysis aims to estimate the economic impact of standard treatment in Mexico for an optimistic scenario of 80% of all breast can-cer population at early stages compared to the actual distribution (55%) of patients along the stages in Mexican setting. Methods: A hypothetical patient cohort of 8765 was evaluated; this estimation was obtained from breast cancer 2011 prevalence in Mexican population. The analysis was developed in order to estimate average cost from the optimistic (base-case) versus actual scenario through public health care perspective. Distribution of population in the actual case scenario was 16%, 39%, 30% and 14% at each stage, I-IV respectively. Direct medical costs were extracted from a published source where through a micro-costing technique the cost at each stage was obtained. Costs are expressed in 2014 USD ($1USD= $13MXN). It is assumed that the economical difference between both scenarios will be used for prevention campaigns. Results: The total cost of treatment for all patients on the actual sce-nario was $124,261,716 compared to $103,549,361 that was the cost calculated at the base-case scenario. Economic impact of optimistic scenario is 17% less than total cost of treatment at the current scenario. This difference, which represents $20,712,355, could be reallocated to diagnose 32,689 more patients at early stages. A sensitivity analysis with a best-case scenario was developed considering 100% of the patients diagnosed during the first two stages where economic benefits were 314% higher than base-case scenario. ConClusions: This analysis suggests that if more public policies focused on breast cancer prevention were implemented, then it may lead to a more optimal reallocation of resources since direct medical costs increase at late stages.PCN73BurdEN of ProstatE CaNCEr aNd futurE NEEd for hEalth CarE sErviCEsPurmonen T.1, Tyrväinen V.2, Kataja V.31Medfiles Ltd, Kuopio, Finland, 2Proper Ltd, Joensuu, Finland, 3Central Finland Health Care District, Jyväskylä, FinlandobjeCtives: Prostate cancer is the most common cancer with a current incidence of 0,18% among the 2,6million Finnish men. Demand on health care resource use is dependent on number of patients needing the service. Patient volumes are increasing throughout Europe due to ageing of the population. Despite the sta-bile or decreasing age-adjusted incidence rates, the absolute number of patients is growing. The population characteristics vary within geographical areas, and thus, using average parameters for the whole country would lead to biased estimates. In this study, burden of prostate cancer cases is estimated on municipality level throughout Finland. Methods: Number of new cancer cases in different hospital districts (N= 20) was extracted from the Finnish cancer registry. Official population statistics and forecast were used to identify the current and predicted age and sex distribution in all of the individual municipalities (N= 320). The data were combined with Tableau (8.0) software, where a map-based interface was constructed. This was also utilized to visualize the population changes and patient forecasts. Similar methodology has been previously utilized in different cancer types. Results: The number of new prostate cancer cases each year is estimated to be 1,5-fold by 2040. As a case example, a Finnish municipality with 135,000 inhabitants was chosen. There were 78 new prostate cancer cases among the 64,332 men in 2011, repre-senting an incidence of 0,12%. According to our analysis, this university city with relatively young population would reach the current country average (0,18%) as late as 2040. ConClusions: The disease burden and population demographics are unevenly distributed across the country, and thus municipality level estimates are needed to inform local decision making and planning. Estimates on the absolute number of patients across relevant disease areas are required in order to prepare to the challenges health care systems are facing in the future.PCN74thE BurdEN of NoN-small CElls luNg CaNCEr (NsClC) iN first liNE (1l) trEatmENt: PattErNs of CarE aNd Cost of illNEssPiedade A., Goes L., Castro A.P., Alves A.F., Minowa E.Evidências Credibilidade Científica, São Paulo, BrazilobjeCtives: Several treatment options are available for 1L NSCLC. In Brazil, patients with NSCLC have not been systematically evaluated and different management strategies may be associated to different economical outcomes. Therefore, we aimed to evaluate the patterns of care and cost of illness of 1L NSCLC treatment according to Brazilian supplementary health system. Methods: Metastatic NSCLC patients receiving 1L treatment during year 2013 were eligible and selected from the private market administrative claims database (Evidencias database). Treatments, demo-graphics, supportive drugs and exams were evaluated. Name and any other personal identification were not available at the database. The most reported treatments according to generic name in 1L therapy were defined as patterns of care. The cost of illness was calculated by a bottom-up approach. Exams and associated drugs In the management of cervical lesions/cervical cancer, the most expensive are the costs of treatment.PCN69ECoNomiC BurdEN of mElaNoma iN thrEE EuroPEaN CouNtriEs:  a rEtrosPECtivE oBsErvatioNal studyKontoudis I.1, Harries M.2, Mohr P.3, Grange F.4, Ehness R.5, Benjamin L.6, Siakpere O.7, Barth J.5, Stapelkamp C.8, Pfersch S.6, McLeod L.9, Kaye J.A.10, Wolowacz S.111GlaxoSmithKline Vaccines, Rixensart, Belgium, 2NHS, London, UK, 3Dermatologic Center Buxtehude, Buxtehude, Germany, 4Reims University Hospital, Reims, France, 5GlaxoSmithKline GmbH & Co KG, Munich, Germany, 6GlaxoSmithKline France, Marly le Roi Cedex, France, 7GlaxoSmithKline UK, Middlesex, UK, 8GlaxoSmithKline, Uxbridge, UK, 9RTI Health Solutions, Research Triangle Park, NC, USA, 10RTI Health Solutions, Waltham, MA, USA, 11RTI Health Solutions, Manchester, UKobjeCtives: To estimate cost-of-illness data associated with treatment of patients with stage IIIB/IIIC melanoma with macroscopic lymph node involvement in France, Germany and the United Kingdom (UK), whose primary melanoma and regional lymph node metastases had been completely resected. Methods: This retrospec-tive observational study enrolled patients aged ≥ 18 years, first diagnosed between 1 January 2009 and 31 December 2011. Data were extracted from medical records and via patient survey. Costs were calculated in Euros (€ ) (France, Germany) or pound sterling (£) (UK) by collecting resource use and multiplying by country-specific unit costs. Costs were estimated from the health care provider perspective. National annual costs were estimated from study results and national disease prevalence estimates based on European cancer registry and other data. Results: 49 centres provided data on 558 patients (55.7% male, 58.2% aged < 65 years at diagnosis, 53.6% stage IIIB disease). Mean follow-up was 27 months in France, 26 months in Germany and 22 months in the UK. Most patients received no adjuvant treatment in France (93.0%) and the UK (97.4%). Use of interferon in Germany was limited (high-dose 11.0%; intermediate-dose 4.9%; low-dose 15.2%; pegylated 1.8%). Mean total direct cost per patient during follow-up was € 23,582 in France, € 32,058 in Germany and £31,123 (€ 37,348) in the UK. The largest cost drivers were melanoma treatment (mean € 14,004 France, € 21,269 Germany and £24,385 UK) and hospitalisation/emer-gency treatment (mean € 6,634 France, € 6,950 Germany and £2,827 UK). Total mean indirect costs per patient were € 129 in France, € 4,441 in Germany and £1,427 (€ 1,712) in the UK. Preliminary estimates for annual national direct cost were € 13.1 million in France, € 30.2 million in Germany and £22.8 (€ 27.6) million in the UK. ConClusions: The economic burden of stage IIIB/IIIC melanoma with macroscopic lymph node involvement was substantial in all three countries. Indirect costs varied by country.PCN70Cost aNd BurdEN of NoN-small CEll luNg CaNCEr’s iN PortugalBorges M.1, Gouveia M.2, Alarcão J.1, Sousa R.1, Teixeira E.3, Barata F.4, Laranjeira E.1, Lopes F.1, Parente B.5, Pinheiro L.1, Vaz-Carneiro A.1, Costa J.11Center for Evidence Based Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal, 2Católica Lisbon School of Business and Economics, Lisbon, Portugal, 3Centro Hospitalar Lisboa Norte, Lisboa, Portugal, Lisbon, Portugal, 4Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal, 5Hospital CUF Porto, Porto, PortugalobjeCtives: This study estimates the impact of Non-Small Cell Lung Cancer (NSCLC) on population health levels and its economic impact in Portugal in 2012.  Methods: Data from a cohort of 581 patients with NSCLC completed with an expert panel was used to develop a model of cumulated prevalence with a 6 months cycle period and a time horizon of 5 years. The impact on health status was measured using the Disability Adjusted Life Years (DALYs). The economic impact analysis includes two components. The first estimates the direct costs generated by NSCLC including consumption of inpatient care and outpatient care (consultations, medi-cation, diagnostic exams, transportation, etc). The second estimates indirect costs related to loss of productivity due to NSCLC. Results: A total of 3,180 deaths in Portugal in 2012 were caused by NSCLC, which corresponds to 2.0% of the total deaths in Portugal. The DALYs resulting from premature deaths caused by NSCLC in 2012 totaled 25,071 representing 4.5% of years lost generated by all deaths in the country. For 2012 it is estimated that 3,236 life years were lost due to disability. The total disease burden attributable to NSCLC is thus estimated at 28,307 DALY. The estimated direct cost generated by NSCLC was € 89 million and that total can be broken down into € 32 million for inpatient care and € 57 million for outpatient care. The indirect costs must also be taken into account and they added up to € 54 million. The economic burden of NSCLC is substantial, totaling € 143 million, about 0.09% of Portuguese GDP and 0.92% of all Portuguese health spending in 2012. ConClusions: NSCLC is an important cause of disease burden and costs in Portugal and should receive adequate attention from policy makers.PCN71mEtastatiC ProstatE CaNCEr aNd skElEtal rElatEd EvENts, a Cost of illNEss studyGeenen J.W.1, Heine ter R.2, Frederix G.W.1, Hövels A.3, Vulpen, van M.4, Kooistra A.2, Klerk de J.M.H.2, Bloemendal H.J.21Utrecht University, Utrecht, The Netherlands, 2Meander Medical Center, Amersfoort, The Netherlands, 3Utrecht Institute for Pharmaceutical Sciences, Division Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands, 4University Medical Centre Utrecht, Utrecht, The NetherlandsobjeCtives: To assess the intramural resource use and associated costs of treating patients with prostate cancer, metastatic to the bone, focusing on Skeletal Related Events (SREs). Secondary, to quantify the impact of SREs and different treatment strategies on total costs. Methods: A retrospective bottom-up cost of illness study performed at a large regional teaching hospital in the Netherlands. Results: A total of 136 patients were included, follow-up started at diagnosis of bone metastases and stopped at death. The mean total costs were EUR 17.931 per patient (median EUR 14.039), inpatient days were the most costly category at a mean of EUR 5955 (median EUR 3995). SREs that required hospitalization (n= 53) were, at median costs of EUR 

Cost and burden of non-small cell lung cancer's in Portugal

A626  VA L U E  I N  H E A LT H  1 7  ( 2 0 1 4 )  A 3 2 3 – A 6 8 6  
2039 to EUR 9346, depending on care required, more costly than SREs without hospi-
talization (n= 165). These SREs had median costs of EUR 200 to EUR 1912, depending 
on care required. ConClusions: The impact of SREs on total costs could justify 
policy aimed at actively preventing SREs, e.g. with radionuclide therapy, possibly 
resulting in better quality of life and cost-reduction. Treatment of prostate cancer 
with bone metastases is not very costly compared to lung-and breast cancer with 
similar metastases. However, novel therapeutic options may dramatically increase 
treatment costs in the near future and proper head-to-head cost-effectiveness stud-
ies of all treatment modalities are therefore necessary.
PCN72
ECoNomiC imPaCt modEl of BrEast CaNCEr trEatmENt at Early stagEs 
iN thE mExiCaN PuBliC hEalth CarE sECtor
Guirant-Corpi L.1, Hernandez-Reyes F.C.1, Kelly J.2, Muciño-Ortega E.1
1Pfizer S.A. de C.V., Ciudad de México, Mexico, 2Centro Médico Nacional Siglo XXI, Mexico City, 
Mexico
objeCtives: Nowadays breast cancer represents a great economic burden to public 
health care sector in Mexico. This economic burden is due by a lack of prevention 
campaigns and late diagnosis. The analysis aims to estimate the economic impact 
of standard treatment in Mexico for an optimistic scenario of 80% of all breast can-
cer population at early stages compared to the actual distribution (55%) of patients 
along the stages in Mexican setting. Methods: A hypothetical patient cohort of 8765 
was evaluated; this estimation was obtained from breast cancer 2011 prevalence in 
Mexican population. The analysis was developed in order to estimate average cost 
from the optimistic (base-case) versus actual scenario through public health care 
perspective. Distribution of population in the actual case scenario was 16%, 39%, 
30% and 14% at each stage, I-IV respectively. Direct medical costs were extracted 
from a published source where through a micro-costing technique the cost at each 
stage was obtained. Costs are expressed in 2014 USD ($1USD= $13MXN). It is assumed 
that the economical difference between both scenarios will be used for prevention 
campaigns. Results: The total cost of treatment for all patients on the actual sce-
nario was $124,261,716 compared to $103,549,361 that was the cost calculated at the 
base-case scenario. Economic impact of optimistic scenario is 17% less than total cost 
of treatment at the current scenario. This difference, which represents $20,712,355, 
could be reallocated to diagnose 32,689 more patients at early stages. A sensitivity 
analysis with a best-case scenario was developed considering 100% of the patients 
diagnosed during the first two stages where economic benefits were 314% higher than 
base-case scenario. ConClusions: This analysis suggests that if more public policies 
focused on breast cancer prevention were implemented, then it may lead to a more 
optimal reallocation of resources since direct medical costs increase at late stages.
PCN73
BurdEN of ProstatE CaNCEr aNd futurE NEEd for hEalth CarE 
sErviCEs
Purmonen T.1, Tyrväinen V.2, Kataja V.3
1Medfiles Ltd, Kuopio, Finland, 2Proper Ltd, Joensuu, Finland, 3Central Finland Health Care 
District, Jyväskylä, Finland
objeCtives: Prostate cancer is the most common cancer with a current incidence 
of 0,18% among the 2,6million Finnish men. Demand on health care resource use 
is dependent on number of patients needing the service. Patient volumes are 
increasing throughout Europe due to ageing of the population. Despite the sta-
bile or decreasing age-adjusted incidence rates, the absolute number of patients is 
growing. The population characteristics vary within geographical areas, and thus, 
using average parameters for the whole country would lead to biased estimates. 
In this study, burden of prostate cancer cases is estimated on municipality level 
throughout Finland. Methods: Number of new cancer cases in different hospital 
districts (N= 20) was extracted from the Finnish cancer registry. Official population 
statistics and forecast were used to identify the current and predicted age and sex 
distribution in all of the individual municipalities (N= 320). The data were combined 
with Tableau (8.0) software, where a map-based interface was constructed. This 
was also utilized to visualize the population changes and patient forecasts. Similar 
methodology has been previously utilized in different cancer types. Results: The 
number of new prostate cancer cases each year is estimated to be 1,5-fold by 2040. 
As a case example, a Finnish municipality with 135,000 inhabitants was chosen. 
There were 78 new prostate cancer cases among the 64,332 men in 2011, repre-
senting an incidence of 0,12%. According to our analysis, this university city with 
relatively young population would reach the current country average (0,18%) as 
late as 2040. ConClusions: The disease burden and population demographics are 
unevenly distributed across the country, and thus municipality level estimates are 
needed to inform local decision making and planning. Estimates on the absolute 
number of patients across relevant disease areas are required in order to prepare 
to the challenges health care systems are facing in the future.
PCN74
thE BurdEN of NoN-small CElls luNg CaNCEr (NsClC) iN first liNE (1l) 
trEatmENt: PattErNs of CarE aNd Cost of illNEss
Piedade A., Goes L., Castro A.P., Alves A.F., Minowa E.
Evidências Credibilidade Científica, São Paulo, Brazil
objeCtives: Several treatment options are available for 1L NSCLC. In Brazil, patients 
with NSCLC have not been systematically evaluated and different management 
strategies may be associated to different economical outcomes. Therefore, we aimed 
to evaluate the patterns of care and cost of illness of 1L NSCLC treatment according 
to Brazilian supplementary health system. Methods: Metastatic NSCLC patients 
receiving 1L treatment during year 2013 were eligible and selected from the private 
market administrative claims database (Evidencias database). Treatments, demo-
graphics, supportive drugs and exams were evaluated. Name and any other personal 
identification were not available at the database. The most reported treatments 
according to generic name in 1L therapy were defined as patterns of care. The cost 
of illness was calculated by a bottom-up approach. Exams and associated drugs 
In the management of cervical lesions/cervical cancer, the most expensive are the 
costs of treatment.
PCN69
ECoNomiC BurdEN of mElaNoma iN thrEE EuroPEaN CouNtriEs:  
a rEtrosPECtivE oBsErvatioNal study
Kontoudis I.1, Harries M.2, Mohr P.3, Grange F.4, Ehness R.5, Benjamin L.6, Siakpere O.7, Barth 
J.5, Stapelkamp C.8, Pfersch S.6, McLeod L.9, Kaye J.A.10, Wolowacz S.11
1GlaxoSmithKline Vaccines, Rixensart, Belgium, 2NHS, London, UK, 3Dermatologic Center 
Buxtehude, Buxtehude, Germany, 4Reims University Hospital, Reims, France, 5GlaxoSmithKline 
GmbH & Co KG, Munich, Germany, 6GlaxoSmithKline France, Marly le Roi Cedex, France, 
7GlaxoSmithKline UK, Middlesex, UK, 8GlaxoSmithKline, Uxbridge, UK, 9RTI Health Solutions, 
Research Triangle Park, NC, USA, 10RTI Health Solutions, Waltham, MA, USA, 11RTI Health 
Solutions, Manchester, UK
objeCtives: To estimate cost-of-illness data associated with treatment of patients 
with stage IIIB/IIIC melanoma with macroscopic lymph node involvement in France, 
Germany and the United Kingdom (UK), whose primary melanoma and regional 
lymph node metastases had been completely resected. Methods: This retrospec-
tive observational study enrolled patients aged ≥ 18 years, first diagnosed between 1 
January 2009 and 31 December 2011. Data were extracted from medical records and 
via patient survey. Costs were calculated in Euros (€ ) (France, Germany) or pound 
sterling (£) (UK) by collecting resource use and multiplying by country-specific unit 
costs. Costs were estimated from the health care provider perspective. National 
annual costs were estimated from study results and national disease prevalence 
estimates based on European cancer registry and other data. Results: 49 centres 
provided data on 558 patients (55.7% male, 58.2% aged < 65 years at diagnosis, 53.6% 
stage IIIB disease). Mean follow-up was 27 months in France, 26 months in Germany 
and 22 months in the UK. Most patients received no adjuvant treatment in France 
(93.0%) and the UK (97.4%). Use of interferon in Germany was limited (high-dose 
11.0%; intermediate-dose 4.9%; low-dose 15.2%; pegylated 1.8%). Mean total direct 
cost per patient during follow-up was € 23,582 in France, € 32,058 in Germany and 
£31,123 (€ 37,348) in the UK. The largest cost drivers were melanoma treatment 
(mean € 14,004 France, € 21,269 Germany and £24,385 UK) and hospitalisation/emer-
gency treatment (mean € 6,634 France, € 6,950 Germany and £2,827 UK). Total mean 
indirect costs per patient were € 129 in France, € 4,441 in Germany and £1,427 (€ 1,712) 
in the UK. Preliminary estimates for annual national direct cost were € 13.1 million in 
France, € 30.2 million in Germany and £22.8 (€ 27.6) million in the UK. ConClusions: 
The economic burden of stage IIIB/IIIC melanoma with macroscopic lymph node 
involvement was substantial in all three countries. Indirect costs varied by country.
PCN70
Cost aNd BurdEN of NoN-small CEll luNg CaNCEr’s iN Portugal
Borges M.1, Gouveia M.2, Alarcão J.1, Sousa R.1, Teixeira E.3, Barata F.4, Laranjeira E.1, Lopes F.1, 
Parente B.5, Pinheiro L.1, Vaz-Carneiro A.1, Costa J.1
1Center for Evidence Based Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal, 
2Católica Lisbon School of Business and Economics, Lisbon, Portugal, 3Centro Hospitalar Lisboa 
Norte, Lisboa, Portugal, Lisbon, Portugal, 4Centro Hospitalar Universitário de Coimbra, Coimbra, 
Portugal, 5Hospital CUF Porto, Porto, Portugal
objeCtives: This study estimates the impact of Non-Small Cell Lung Cancer 
(NSCLC) on population health levels and its economic impact in Portugal in 2012.  
Methods: Data from a cohort of 581 patients with NSCLC completed with an expert 
panel was used to develop a model of cumulated prevalence with a 6 months cycle 
period and a time horizon of 5 years. The impact on health status was measured 
using the Disability Adjusted Life Years (DALYs). The economic impact analysis 
includes two components. The first estimates the direct costs generated by NSCLC 
including consumption of inpatient care and outpatient care (consultations, medi-
cation, diagnostic exams, transportation, etc). The second estimates indirect costs 
related to loss of productivity due to NSCLC. Results: A total of 3,180 deaths in 
Portugal in 2012 were caused by NSCLC, which corresponds to 2.0% of the total 
deaths in Portugal. The DALYs resulting from premature deaths caused by NSCLC 
in 2012 totaled 25,071 representing 4.5% of years lost generated by all deaths in 
the country. For 2012 it is estimated that 3,236 life years were lost due to disability. 
The total disease burden attributable to NSCLC is thus estimated at 28,307 DALY. 
The estimated direct cost generated by NSCLC was € 89 million and that total can 
be broken down into € 32 million for inpatient care and € 57 million for outpatient 
care. The indirect costs must also be taken into account and they added up to € 
54 million. The economic burden of NSCLC is substantial, totaling € 143 million, 
about 0.09% of Portuguese GDP and 0.92% of all Portuguese health spending in 
2012. ConClusions: NSCLC is an important cause of disease burden and costs in 
Portugal and should receive adequate attention from policy makers.
PCN71
mEtastatiC ProstatE CaNCEr aNd skElEtal rElatEd EvENts, a Cost of 
illNEss study
Geenen J.W.1, Heine ter R.2, Frederix G.W.1, Hövels A.3, Vulpen, van M.4, Kooistra A.2, Klerk de 
J.M.H.2, Bloemendal H.J.2
1Utrecht University, Utrecht, The Netherlands, 2Meander Medical Center, Amersfoort, The 
Netherlands, 3Utrecht Institute for Pharmaceutical Sciences, Division Pharmacoepidemiology & 
Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands, 4University Medical Centre 
Utrecht, Utrecht, The Netherlands
objeCtives: To assess the intramural resource use and associated costs of treating 
patients with prostate cancer, metastatic to the bone, focusing on Skeletal Related 
Events (SREs). Secondary, to quantify the impact of SREs and different treatment 
strategies on total costs. Methods: A retrospective bottom-up cost of illness study 
performed at a large regional teaching hospital in the Netherlands. Results: A total 
of 136 patients were included, follow-up started at diagnosis of bone metastases and 
stopped at death. The mean total costs were EUR 17.931 per patient (median EUR 
14.039), inpatient days were the most costly category at a mean of EUR 5955 (median 
EUR 3995). SREs that required hospitalization (n= 53) were, at median costs of EUR 


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Cost and burden of non-small cell lung cancer's in Portugal

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