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HCRU and treatment-related costs were compared in two matched cohorts of patients with and without a history of SREs, defined as pathological fracture, spinal cord compression, surgery to bone and radiation to bone. The first SRE was defined as the patient-individual index date. Conversely, for the non-SRE patients, index dates were assigned randomly.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In total, 45.20% of 9,832 patients reported experiencing at least one SRE (<jats:italic>n<\/jats:italic>\u2009=\u20094444) while 54.80% experienced none (<jats:italic>n<\/jats:italic>\u2009=\u20095388); 2,434 pairs of SRE and non-SRE patients were finally matched (mean age: 70.87\/71.07\u00a0years; females: 39.07%\/38.58%). Between SRE and non-SRE cohorts, significant differences in the average number of hospitalization days per patient-year (35.80\/30.80) and associated inpatient-care costs (14,199.27\u20ac\/10,787.31\u20ac) were observed. The total cost ratio was 1.16 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) with an average cost breakdown of 23,689.54\u20ac and 20,403.27\u20ac per patient-year in SRE and non-SRE patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The underutilization of BTAs within a clinical setting poses an ongoing challenge in the real-world treatment of BM patients throughout Germany. Ultimately, the economic burden of treating SREs in patients with BM from ST was found to be considerable, resulting in higher direct healthcare costs and increased utilization of inpatient care facilities.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10198-020-01247-z","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T13:07:19Z","timestamp":1610975239000},"page":"243-254","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Healthcare resource utilization and associated cost of patients with bone metastases from solid tumors who are na\u00efve to bone-targeting agents: a comparative analysis of patients with and without skeletal-related events"],"prefix":"10.1007","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4698-1628","authenticated-orcid":false,"given":"Fr\u00e4nce","family":"Hardtstock","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeki","family":"Kocaata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Wilke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Dittmar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ghiani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasily","family":"Belozeroff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Harrison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Maywald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Tesch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,18]]},"reference":[{"issue":"10","key":"1247_CR1","doi-asserted-by":"publisher","first-page":"3859","DOI":"10.1007\/s00520-019-04676-6","volume":"27","author":"A Mjelstad","year":"2019","unstructured":"Mjelstad, A., Zakariasson, G., Valachis, A.: Optimizing antiresorptive treatment in patients with bone metastases: time to initiation, switching strategies, and treatment duration. 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Harrison are employees and shareholders of Amgen. Fr\u00e4nce Hardtstock and Zeki Kocaata have no conflict of interest to declare. Thomas Wilke has acted as a consultant for Boehringer Ingelheim Pharma, Bayer Health Care, GSK, Novartis, Sanofi-Aventis, Bristol Myers Squibb, Pfizer and other pharmaceutical companies. Marco Ghiani and Axel Dittmar are employees of IPAM and do not have any conflict of interest to declare. Ulf Maywald works for one of the insurance funds that provided the study data (AOK PLUS). Hans Tesch, who is working as a physician in the field of oncology, supported the study as a scientific advisor and received honoraria from Amgen, Novartis, Pfizer and other pharmaceutical companies.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Due to the non-interventional, retrospective nature of this study and because our analysis involved an anonymized dataset, neither ethical review nor informed consent of the patients was required. However, the study protocol was reviewed and approved by the sickness fund (AOK PLUS), before access to the data was granted.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}