Health care resource use and costs among patients with carcinoid syndrome in France: Analysis of the National Health Insurance Database

Objectives: Carcinoid syndrome (CS) develops in approximately 20% of patients with neuroendocrine tumours (NET). This study described healthcare resource utilization and its associated costs among patients with NET and CS, using the French national health care data system. Methods: Patients were included if they had a hospital stay associated with the code E34.0 "CS" and at least one delivery of a somatostatin analogue (SSA) between 01/01/2012 and 31/12/2016. The end of the analysis was either 31/12/2017 or the date of death, whichever occurred first. Mean overall costs were described by item of expenditure and by periods. Results: 646 patients were included: 64yo, 55% men, 64% and 15% had NET from the small-intestine or lung, respectively. Among them, 309 patients were incident and 271 died during the study period. Mean overall cost per person per month (PPPM) was euro2,892: euro3,273 for the first year following diagnosis, euro2,574 in "middle-years" and euro5,039 within the year preceding death. The two most costly expenditure items were drugs (euro1,695 PPPM) and hospital stays (euro870 PPPM). Conclusion: The first year following diagnosis and the year preceding death are the two periods representing the highest costs for CS care in France. Successful disease management may contribute to lower costs in the inter-mediate period.