PCN27 - Evaluation of the Healthcare Costs and Utilization of Patients with Metastatic Breast Cancer

Abstract

To determine the economic burden of metastatic breast cancer (MBC) in Taiwan, we conducted a national retrospective study to evaluate the incremental healthcare costs and utilization of MBC patients as compared to their breast cancer (BC) and breast cancer free (BCF) counterparts. Data were obtained from the Longitudinal Health Insurance Database (LHID) and the Taiwan Cancer Registry database between 2012 to 2015. Patients with MBC were identified by (1) the 7th Edition of cancer staging system of the American Joint Committee on Cancer (AJCC), and (2) having at least one diagnosis of secondary malignant neoplasm in a claim. The identified MBC patients were then matched with BC and BCF patients on a 1:2:2 basis by age, gender, residential region, and the Charlson Comorbidity Index. Each selected beneficiary was then followed from the index date (i.e., first diagnosis of BC/MBC or a random date in 2012 for the BCF group) to death or December 31, 2015, the censoring date. All healthcare utilization and costs were calculated on a per person per month (PPPM) basis. A total of 2,637 MBC patients were identified and matched to 5,274 BC patients and 5,274 BCF patients. MBC patients had significantly greater healthcare utilization than the other two groups, with an average of 0.2/8.3/0.1 inpatient/outpatient/ER monthly visits, compared to 0.2/7.2/0.1 visits in the BC group and 0.1/5.5/0.1 visits in the BCF group. In addition, the mean total healthcare monthly costs of MBC, BC, and BCF group were NTD$85,146.9, $21,310.4, and $9,293.3, respectively. Outpatient, inpatient, emergency room, and total medication costs accounted for 40.8%, 39.2%, 20.1%, and 29.7% of MBC total healthcare costs, respectively. Patients with MBC are associated with substantial economic burden. The study findings could be useful for MBC-related economic evaluations and health resource allocation.