PCN132 SYSTEMATIC REVIEW OF ECONOMIC BURDEN IN TRIPLE-NEGATIVE BREAST CANCER PATIENTS

Abstract

This study was conducted to gather available evidence from the literature on the economic burden of triple-negative breast cancer (TNBC). A systematic literature review (SLR) was completed in April 2019. EMBASE, MEDLINE, EconLit, and CENTRAL were searched to identify studies describing healthcare resource utilization and cost data in TNBC patients. Manual searches of relevant conference proceedings and health technology assessment (HTA) databases were also conducted. Of the 4 bibliographic databases (2007-2019), 7 congresses (2017-2019), and 11 HTA databases (2007-2019) reviewed, 9 studies were included. The study designs were varied and included two cost-utility analyses, one health technology assessment, three observational cohort studies, one retrospective database analysis, one targeted literature review, and one value of information analysis. Data sources for healthcare resource utilization included several large registries of patients in the United States. There was significant heterogeneity in disease stage, line of therapy, and cost outcomes measured, precluding quantitative synthesis of outcomes. Mean monthly hospitalizations per-patient were high (range across studies and subgroups: 0.5-1.5) and increased with line of treatment and stage of disease. Additionally, mean monthly total direct medical costs in the United States for advanced TNBC across all lines of therapy varied by subgroup and ranged from $3,651 to $24,962. Furthermore, in one study, TNBC patients were found to have greater inpatient costs, emergency department costs, and “other costs” than general breast cancer patients. In this study, total mean annual costs—including pharmacy costs—associated with stage I-III disease were $95,338 for TNBC patients and $90,947 for non-TNBC patients. An SLR of economic studies demonstrated substantial healthcare resource utilization and costs in TNBC patients. Costs differed by subgroup and line of treatment with greater costs of treatment associated with increasing stage of disease and treatment line.