Incentive, Holte Stationsvej 14, 1, 2840, Holte, Denmark.
Roche Denmark, Hvidovre, Denmark.
BMC Health Serv Res. 2022 Jun 4;22(1):745. doi: 10.1186/s12913-022-08143-7.
Information and knowledge about cost of illness and labour productivity in patients with HER2-positive early-stage and metastatic breast cancer treated with trastuzumab is limited. The aim of this study was to estimate the direct and indirect costs associated with treatment of HER2-positive breast cancer among patients with early-stage and metastatic breast cancer, treated with trastuzumab, in a 10-year period after diagnosis.
This study included all Danish HER2-positive breast cancer patients (≥ 18 years) treated with trastuzumab between 2005 and 2016 identified in The Danish Patient Register and the Danish Cancer Register. Furthermore, we identified patients experiencing metastatic or recurrent breast cancer. For the study populations, we estimated total direct costs and indirect costs for one year prior to the breast cancer diagnosis and up to 10 years after diagnosis compared with a group of matched controls free of breast cancer. In addition to The Danish Patient Register and Cancer Register, we applied patient level data from The Civil Registration System, The National Pathology Register, National Health Service Register for Primary Care, Register of Medicinal Product Statistics, Register of Municipal Services, The DREAM database, and Population's Education Register.
We identified 4,153 HER2-positive breast cancer patients, whereof 27% were identified with metastatic or recurrent breast cancer. During the follow-up period of 10 years, we estimated excess direct costs of EUR 115,000 among the total study population compared to controls; EUR 211,000 among patients with metastases or recurrence; and EUR 89,000 among patients without metastases or recurrence. Direct costs were found to be highest in the first year after diagnosis and also peaked in the year after recurrence. Labour productivity was significantly lower among patients with recurrence 10 years after breast cancer diagnosis compared with controls.
In this study, we estimated the direct and indirect cost associated with HER2-positive breast cancer. The costs were significantly higher during the 10 years after diagnosis compared to the control group, specifically among patients experiencing metastases or recurrence of breast cancer.
关于曲妥珠单抗治疗 HER2 阳性早期和转移性乳腺癌患者的疾病成本和劳动力生产力的信息和知识有限。本研究的目的是在诊断后 10 年内，估计接受曲妥珠单抗治疗的 HER2 阳性早期和转移性乳腺癌患者的治疗相关直接和间接成本。
本研究包括在 2005 年至 2016 年期间在丹麦患者登记处和丹麦癌症登记处确定的所有接受曲妥珠单抗治疗的丹麦 HER2 阳性乳腺癌患者（≥18 岁）。此外，我们还确定了患有转移性或复发性乳腺癌的患者。对于研究人群，我们在乳腺癌诊断前一年和诊断后 10 年内估计了与一组无乳腺癌的匹配对照者相比的总直接成本和间接成本。除了丹麦患者登记处和癌症登记处外，我们还应用了来自民事登记系统、国家病理学登记处、初级保健国家卫生服务登记处、药品统计登记处、市政服务登记处、DREAM 数据库和人口教育登记处的患者水平数据。
我们确定了 4153 例 HER2 阳性乳腺癌患者，其中 27%的患者被诊断为转移性或复发性乳腺癌。在 10 年的随访期间，我们估计与对照组相比，整个研究人群的直接超额成本为 11.5 万欧元；在有转移或复发的患者中为 21.1 万欧元；在无转移或复发的患者中为 8.9 万欧元。在诊断后的第一年直接成本最高，在复发后的第二年也达到峰值。与乳腺癌诊断 10 年后的对照组相比，复发患者的劳动力生产力显著降低。
在这项研究中，我们估计了与 HER2 阳性乳腺癌相关的直接和间接成本。与对照组相比，在诊断后 10 年内，这些成本显著增加，特别是在患有转移性或复发性乳腺癌的患者中。
