OBJECTIVES: To assess healthcare resource utilization (HRU) and costs in patients with locally advanced or metastatic urothelial carcinoma (la/mUC) in China.

METHODS: Electronic medical records of adult patients with UC from the China National Cancer Center Oncology Information Database were examined (January 2015–December 2022). HRU and costs were estimated following la/mUC diagnosis (January 2016–June 2022).

RESULTS: Of 112,536 patients diagnosed with UC during the study period, approximately 24.1% (27,067/112,536) were stage III/IV at diagnosis. This analysis included 7,851 eligible patients with la/mUC. At each line of treatment, more than half of patients with recorded treatment received chemotherapy (1^st: 73.2%, 2,951/4,031; 2^nd: 51.6%, 396/768, 3^rd: 50.5%, 93/184). Overall, 72.2% (5,670/7,851) of patients had an UC-related inpatient admission (incidence rate of 0.30 per patient month [PM]; 95% CI, 0.29–0.30), cumulative incidence risk of 76.4% over 12 months follow-up, and mean length of stay per inpatient admission of 39.8 days (standard deviation [SD] 44.6). Additionally, 51.8% (4,068/7,851) of patients had an UC-related outpatient visit (incidence rate of 0.44 per PM; 95% CI, 0.43–0.44), and cumulative incidence risk of 59.1% over 12 months’ follow-up. Both UC-related costs per PM (mean ± SD: 3,149.93 ± 3,534.80 vs 32.16 ± 153.90 Euros [€; 1 Euro = CNY 7.4229 Dec 30 2022]) and per admission (€3,680.66 ± 14,092.13 vs €245.34 ± 1,141.23) were higher for inpatient compared with outpatient visits. Mean treatment costs per PM were €703.55 ± 1,107.11 for programmed death receptor 1 (PD-1)/ligand 1 (PD-L1) inhibitors and €834.12 ± 348.33 for disitamab vedotin (antibody-drug conjugate), whereas prescription costs were €369.03 ± 1,087.92 and €310.15 ± 534.00, respectively.

CONCLUSIONS: This is the first real-world study to determine HRU and costs of la/mUC in China. Most patients had UC-related inpatient admissions within 12 months of follow-up, incurring substantially higher costs than outpatient visits.