Treatment patterns, adverse events, and direct and indirect economic burden in a privately insured population of patients with HR+/HER2– metastatic breast cancer in the United States. (4th July 2021)

• Record Type: Journal Article
• Authors: Goyal, Ravi K.; Cuyun Carter, Gebra; Nagar, Saurabh P.; Nash Smyth, Emily; Price, Gregory L.; Parikh, Rohan C.; Huang, Yu-Jing; Li, Li; Davis, Keith L.; Kaye, James A.
• Is Part Of: Expert review of pharmacoeconomics & outcomes research. Volume 21:Number 4(2021)
• Page Start: 699
• Page End: 710
• Publication Date: 2021-07-04
• Subjects: Adverse events -- healthcare use -- healthcare costs -- metastatic breast cancer -- productivity loss -- treatment patterns; Pharmacology -- Economic aspects -- Periodicals; 338.47615105
• DOI: 10.1080/14737167.2020.1804871
• Languages: English
• ISSNs: 1473-7167

Abstract

ABSTRACT: Background: Real-world evidence specific to HR+/HER2– metastatic breast cancer (MBC) prior to introduction of CDK4/6 inhibitors is limited. In an effort to provide context for the introduction of new treatments, we assessed treatment patterns, adverse events, productivity loss, and direct/indirect economic burden in a privately insured population of patients with HR+/HER2– MBC. Research design and methods: Using a retrospective cohort design, patients aged 18–64 years, selected from MarketScan databases (2007–2014), were analyzed using descriptive and multivariable methods. Results: Among 5, 563 eligible patients, endocrine therapy was the most common first-line (1L) therapy; its utilization trended downward from 63% (1L) to 23% (4L), with a simultaneous increase in chemotherapy use, 25% (1L) to 50% (4L). Two hundred and seventy-eight unique treatment regimens were used in the 1L setting. The average per patient monthly all-cause costs were $14, 424. The 12-month indirect costs for short-term disability were substantially higher in MBC patients ($10, 397) than in matched noncancer patients ($394). Conclusion: The increasing use of chemotherapy as patients progressed to second and later lines and the substantial direct/indirect economic burden underscore an unmet need. The high number of 1L regimens highlights significant heterogeneity and a lack of consensus related to the management of HR+/HER2– MBC in routine practice.