Analysis Group, Inc, Montreal, QC, H3B 4W5, Canada.
Novartis Pharmaceuticals Corporation, East Hanover, NJ, 07936, USA.
Adv Ther. 2018 Apr;35(4):503-514. doi: 10.1007/s12325-018-0689-x. Epub 2018 Mar 20.
Premenopausal women with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) metastatic breast cancer (mBC) have complex treatment needs and may receive sequential combinations of endocrine therapy (ET) or chemotherapy. This study describes healthcare utilization (HRU) and costs among premenopausal women with HR+/HER2- mBC in real-world settings from a payer's perspective.
In this retrospective cohort study, premenopausal women with HR+/HER2- mBC who received ET or chemotherapy were identified from the Truven Health Analytics MarketScan database (1 January 2006-31 December 2015). The main HRU outcomes per patient per 6 months (PPP6 M) were measured during each line of therapy and included number of days in inpatient (IP) and outpatient (OP) services. Healthcare costs per patient per month (PPPM) included medical and pharmacy costs.
A total of 3203 patients received first-line, 2194 received second-line, and 1242 received third-line therapy for mBC. Mean number of IP days PPP6 M were 1.6, 1.3, and 1.5 days in the first, second, and third lines, respectively. Mean number of days with OP services PPP6 M was 31.4, 30.9, and 23.3 in the first, second, and third lines, respectively. Among patients receiving ET, mean total healthcare costs were $6521, $4440, and $4555 PPPM in the first, second, and third line, respectively. Among patients receiving chemotherapy, mean total healthcare costs were $16,842, $12,868, and $16,129 PPPM in the first, second, and third line, respectively. These costs were mainly driven by treatment and OP costs.
Real-world HRU and costs among premenopausal women with HR+/HER2- mBC are extensive. Patients who received chemotherapy incurred approximately twice the costs of patients treated with ET.
Novartis Pharmaceutical Corp.
激素受体阳性/人表皮生长因子受体 2 阴性（HR+/HER2-）的绝经前转移性乳腺癌（mBC）患者具有复杂的治疗需求，可能会接受内分泌治疗（ET）或化疗的序贯联合治疗。本研究从支付者的角度描述了 HR+/HER2- mBC 绝经前女性的实际医疗保健利用情况（HRU）和成本。
在这项回顾性队列研究中，从 Truven Health Analytics MarketScan 数据库（2006 年 1 月 1 日至 2015 年 12 月 31 日）中确定了接受 ET 或化疗的 HR+/HER2-mBC 绝经前女性。每位患者每 6 个月（PPP6M）的主要 HRU 结果是在每条治疗线中测量的，包括住院（IP）和门诊（OP）服务的天数。每位患者每月的医疗保健成本（PPPM）包括医疗和药品成本。
共有 3203 例患者接受一线、2194 例患者接受二线和 1242 例患者接受三线 mBC 治疗。在一线、二线和三线治疗中，患者 PPP6M 的平均 IP 天数分别为 1.6、1.3 和 1.5 天。在一线、二线和三线治疗中，患者 PPP6M 的平均 OP 服务天数分别为 31.4、30.9 和 23.3 天。接受 ET 治疗的患者中，一线、二线和三线的总医疗保健费用分别为 PPPM6521、4440 和 4555 美元。接受化疗的患者中，一线、二线和三线的总医疗保健费用分别为 PPPM16842、12868 和 16129 美元。这些成本主要由治疗和 OP 费用驱动。
HR+/HER2- mBC 绝经前女性的实际 HRU 和成本很高。接受化疗的患者的成本大约是接受 ET 治疗的患者的两倍。
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