Disease-phase-specific resource utilization and healthcare costs in metastatic colorectal cancer: a subgroup analysis of the finnish RAXO study - UTU Tutkimustietojärjestelmä

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Disease-phase-specific resource utilization and healthcare costs in metastatic colorectal cancer: a subgroup analysis of the finnish RAXO study

Tekijät: Kontiainen, Joel; Lehtomäki, Kaisa; Muhonen, Timo; Heervä, Eetu; Ålgars, Annika; Ristamäki, Raija; Stedt, Hanna; Lamminmäki, Annamarja; Kallio, Raija; Salminen, Tapio; Kuopio, Teijo; Osterlund, Emerik; Aho, Sonja; Bärlund, Maarit; Halonen, Päivi; Soveri, Leena-Maija; Nordin, Arno; Uutela, Aki; Glimelius, Bengt; Isoniemi, Helena; Osterlund, Pia

Kustantaja: Taylor and Francis Group

Julkaisuvuosi: 2025

Lehti: Scandinavian Journal of Gastroenterology

ISSN: 0036-5521

eISSN: 1502-7708

DOI: https://doi.org/10.1080/00365521.2025.2594779

Julkaisun avoimuus kirjaamishetkellä: Avoimesti saatavilla

Julkaisukanavan avoimuus : Osittain avoin julkaisukanava

Verkko-osoite: https://doi.org/10.1080/00365521.2025.2594779

Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/505763255

Tiivistelmä

Introduction

Metastatic colorectal cancer (mCRC) represents a growing burden on healthcare, yet comprehensive data on treatment costs across different disease phases remain limited. This study aims to estimate hospital resource utilization and costs of treating mCRC patients according to international up-to-date guidelines.

Materials and methods

The RAXO study aimed at maximising metastasectomy with repeated centralized assessment of resectability (inclusion 2012–2018). Cost data from the six largest Finnish hospital districts (n = 941) in RAXO were collected from mCRC diagnosis to death or the end of 2021. All patient costs were characterized day-by-day to diagnostic, curative, remission, palliative SACT, treatment break, or end-of-life disease phases. The resource utilization and mean costs, in 2021 euros, were calculated per patient per month (PPPM).

Results

The mean PPPM cost for treating mCRC patients was 2323€, when 37% had curative-intent metastasectomy. On average, each month included 0.7 ward days, 1.9 outpatient and 0.1 emergency visits. Outpatient care accounted for 64% of costs, inpatient care for 34%, and emergency room visits for 2%. The higher costs during disease phases involving active tumour-directed treatments (2963€–3059€/PPPM) were balanced by lower costs during remission and treatment break (453€–560€/PPPM). Pharmacy, ward, operating room, and outpatient costs (39%/18%/15%/15%, respectively) were the main drivers for internal hospital billing.

Conclusions

Resource utilization, costs, and cost drivers varied 8-fold between disease phases. Outpatient care accounted for two-thirds, and inpatient care accounted for one-third of costs.

Ladattava julkaisu

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Disease-phase-specific resource utilization and healthcare costs in metastatic colorectal cancer a subgroup analysis of the finnish RAXO study.pdf

Julkaisussa olevat rahoitustiedot:
All authors report institutional research funding from Eli Lilly, Merck KGaA, Roche Finland, Sanofi and unrestricted grants from Amgen and Servier, during the conduct of the study. J.K., K.L., T.M., E.H., A.Å., R.R., H.S., am, R.K., T.S., T.K., E.O., S.A., M.B., P.H., L-M.S., A.N., A.U., B.G., H.I., and P.O. report grants, personal fees or non-financial support from Abbvie, Amgen, Astellas, Astra- Zeneca, Baxalta/Shire, Bayer, BMS, Celgene, Eisai/Ewopharma, Eli Lilly, Erythech Pharma, Fresenius, Incyte, Jansen-Cilag, Medicom, Merck, MSD, Nordic Drugs/Pharma, Novartis, Nutricia/Danone, Pierre-Fabre, Roche, Sanofi, Servier, Sobi, Takeda, and/or Varian.

This investigator-initiated study was supported by Finska Läkaresällskapet (2016, 2018, 2019, 2020, 2021, 2022, 2023, 2024, 2025), The Finnish Cancer Foundation (2019–2020, 2021, 2022–2023, 2025), Relander′s foundation (2020–2022), The Competitive State Research Financing of the Expert Responsibility Area of Tampere, Helsinki, Turku, Kuopio, Oulu, and Satakunta Hospitals (2012, 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023, 2024, 2025), Tampere University Hospital Fund (Tukisäätiö 2019, 2020, 2023, 2024 and OOO-project 2020, 2022), Helsinki University Hospital research fund (2019, 2020, 2021, 2022, 2023, 2024), Mary and Georg C. Ehrnrooth Foundation (2023), Liv & Hälsa (2023), Radiumhemmets fonder (2022–2023, 2025–2026), Cancerfonden (2023–2024); and the infrastructure with the database and study nurses partly supported by pharmaceutical companies: Amgen—unrestricted grant (2012–2024), Eli Lilly and Company (2012–2017), Merck KGaA (2012–2020), Roche Oy (2012–2020), Sanofi (2012–2017), and Servier—unrestricted grant (2016–2024). J.K. report personal grants from Suomen Lääketieteen Säätiö [2025] and Juhani Ahon Lääketieteen Tutkimussäätiö [2025]. The funders had no role in the study design, analysis, interpretation of the data or decision to publish.