Abstract P3-12-05: Estimating costs of relapsing HER2+ breast cancer in Spain

Abstract

Abstract OBJECTIVES: The purpose of this study was to describe the economic impact of recurrences (locoregional or unresectable/metastatic recurrences [MR]) in patients with HER2+ breast cancer (BC) in Spain. METHODS: A Delphi panel of 15 Spanish oncologists was carried out to define the clinical management (patients' flow and healthcare resources use) of locoregional recurrences (LR) and unresectable or MR in patients with HER2+ BC. Healthcare resources included medication, medical visits, lab and imaging tests, hospitalizations, surgery, adverse events management and treatment of specific metastases (e.g. bone metastases). Additionally, loss of productivity was also estimated. Local unit costs where used in combination with healthcare resources and workdays lost to estimate both the direct and indirect costs of LR and MR in HER2+ BC patients. A deterministic sensitivity analysis was performed to explore the robustness and assess the critical variables of the study. RESULTS: The estimated distribution of recurrences in HER2+ BC patients was: 90% of MR, 7% of LR and 3% of LR followed by an MR. With respect to MRs, 31% of cases were estimated to receive up to 5 lines of treatment whilst 5% received no treatment (10%, 20% and 21% would receive 2, 3 and 4 treatment lines, respectively, with a median of 3 lines). Treatment regimens including trastuzumab were the most frequently used (in combination with pertuzumab and taxane in 1L, and with other combinations in 4&5L). In 3L, the most common treatment regimen was lapatinib-capecitabine. Total costs, including medical and indirect costs were €235,138, being the direct costs more than 88.7% (€208,682). Both direct and total costs were higher in patients being treated with a higher number of treatment lines, with figures ranging from €38,511 (1L) to €308,869 (5L) and €50,908 (1L) and €358,000 (5L) respectively. CONCLUSIONS: HER2+ BC patients with a MR were estimated to receive a median of 3 treatment lines and almost one third receives 5 treatment lines. The direct and indirect costs of recurrences are high, with a calculated average total cost of €235,138. Using targeted therapies in earlier stages of HER2+ BC that achieve a reduction of recurrences would achieve significant cost savings in Spain. Citation Format: Colomer R, Ciruelos E, De la Haba J, Martín M, De Salas-Cansado M, Muñoz-Molina B, Albanell J. Estimating costs of relapsing HER2+ breast cancer in Spain [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-12-05.