Objectives To estimate the prevalence of prostate cancer with bone metastasis in Beijing, and to estimate hospital visits and direct treatment costs among male urban employees with the disease in Beijing.
Design Cross-sectional observational study.
Setting and participants Patients with prostate cancer and bone metastasis from the Urban Employee Basic Medical Insurance database covering the employed population of Beijing, China, from 2011 to 2014.
Primary and secondary outcome measures Prevalence, treatment costs and healthcare visits of patients with prostate cancer and bone metastasis.
Results A total of 1672 individuals were identified as having prostate cancer. Of these, 737 (44.1%) had bone metastasis, and among these, this was already present at the time of initial prostate cancer diagnosis in 27.0% (199/737). Mean age was 74.6 years (SD ±9.1). Prevalence of prostate cancer with bone metastasis increased from 5.3 per 100 000 males in 2011 to 8.3 per 100 000 males in 2014. The total annual health expenditure per patient (in 2014 American dollars) during the study period was $15 772.1 (SD=$16 942.6) ~$18 206.3 (SD=$18 700.2); 88% of these costs were reimbursed by insurance. Medication accounted for around 50% of total healthcare costs. Western drugs accounted for over 80% of medical costs with endocrine therapy being the most commonly prescribed treatment. There was an average 6.7% increase in expenditure related to diagnostical and therapeutical procedures over study years.
Conclusions The increase in the prevalence of prostate cancer with bone metastasis and associated healthcare costs in China reveals the growing clinical and economical burden of this disease. The high prevalence of bone metastasis among patients with prostate cancer seen in our study suggests that efforts may be needed to improve symptoms awareness and promote early help-seeking behaviour among the Chinese population.
- prostate cancer with bone metastasis
- administrative claims database
- treatment costs
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Contributors LZ performed the statistical analysis and wrote the manuscript. LZ, YC, YP and SZ contributed to the study design, interpretation of the data and the discussion of the manuscript. JZ, WS, LX, MS, YS and JL contributed to the manuscript revise and provided clinical support. All the authors supplied critical revisions to the manuscript and gave approval of the final version of the manuscript to be published.
Funding This work was supported by the National Natural Science Foundation of China (91646107) and Bayer AG, Berlin, Germany (89300-4432 101 080).
Competing interests We have read and understood BMJ policy on declaration of interests and declare the following interests: Jihong Zong is an employee of Epidemiology, Bayer US. WentaoSun and Lin Xu are employees of HEOR and Medical Affairs, Bayer Healthcare Co, Ltd. Montse Soriano-Gabarró is an employee of Epidemiology, Bayer AG, Berlin, Germany. All other authors report no potential conflict of interest.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Extracted data that support the findings of this study are available from Beijing Municipal Health Insurance Bureau but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of Beijing Municipal Health Insurance Bureau.
Patient consent for publication Not required.
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