Abstract
ObjectivesPolicy makers increasingly seek to complement data from clinical trials with information from routine care. This study aims to provide a detailed account of the hospital resource use and associated costs of patients with advanced breast cancer in The Netherlands. MethodsData from 597 patients with advanced breast cancer, diagnosed between 2010 and 2014, were retrieved from the Southeast Netherlands Advanced Breast Cancer Registry. Database lock for this study was in October 2017. We report the observed hospital costs for different resource categories and the lifetime costs per patient, adjusted for censoring using Lin’s method. The relationship between patients’ characteristics and costs was studied using multivariable regression. ResultsThe average (SE) lifetime hospital costs of patients with advanced breast cancer were €52 709 (405). Costs differed considerably between patient subgroups, ranging from €29 803 for patients with a triple-negative subtype to €92 272 for patients with hormone receptor positive and human epidermal growth factor receptor 2 positive cancer. Apart from the cancer subtype, several other factors, including age and survival time, were independently associated with patient lifetime costs. Overall, a large share of costs was attributed to systemic therapies (56%), predominantly to a few expensive agents, such as trastuzumab (15%), everolimus (10%), and bevacizumab (9%), as well as to inpatient hospital days (20%). ConclusionsThis real-world study shows the high degree of variability in hospital resource use and associated costs in advanced breast cancer care. The presented resource use and costs data provide researchers and policy makers with key figures for economic evaluations and budget impact analyses.
Highlights
Breast cancer is the most common type of cancer among women and a leading cause of death worldwide.[1]
Even though some patients live with advanced breast cancer (ABC) for many years, the disease is considered incurable, and the main objective of care is to prolong survival and sustain quality of life
This study used patients included from the Southeast Netherlands Advanced Breast Cancer (SONABRE) Registry.[13]
Summary
Breast cancer is the most common type of cancer among women and a leading cause of death worldwide.[1] Despite significant improvements in the early diagnosis and treatment of breast cancer, about 5% of the patients present with advanced (ie, metastatic) disease at the time of diagnosis, and a further 20% of patients will experience progression to advanced disease later in life.[2] Even though some patients live with advanced breast cancer (ABC) for many years, the disease is considered incurable, and the main objective of care is to prolong survival and sustain quality of life. Due to its high prevalence and high individual treatment costs, the economic burden of ABC in The Netherlands, as well as in many other countries, is substantial.[3,4,5,6]. Over the last 2 decades, several new drugs for the treatment of ABC have become available. Many are highly expensive, posing a substantial economic burden on society and raising questions regarding their value for money.[6,7] Health economic evaluations are essential to inform reimbursement decisions for these novel agents
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