Resource Utilization in Patients with Bisphosphonate - Associated Osteonecrosis of the Jaw

Abstract

Bisphosphonate-associated osteonecrosis of the jaw (BONJ) is an emerging oralcomplication that occur secondary to cancer therapy in approximately 5% of cancerpatients that are treated with high dosages of intravenous (IV) bisphosphonates andcan be associated with significant health-care associated costs.A retrospective electronic medical record based on review of ninety-four cancerpatients with BONJ. All health care related resources were abstracted using astructured chart abstraction tool, including medications, imaging, pathology,procedures, and visits. Standardized references were used to assign costs.The median cost of a case of BONJ in our cohort was $1,546 (interquartile rangefrom $869-$3,166). Medication costs comprise 48%, visits 23%, procedures 16%,imaging 10% and pathology 2%. The major contributing factors that affect BONJtreatment cost were long term medication and follow up visitsLong term medication, sequestrectomy and debridement are a bit expensive butcould be a part of evidence-based successful clinical outcome. The cost of BONJtreatment is modest compared with the cost of cancer care.