Economic Burden of Triple-Negative Breast Cancer in Portugal

OBJECTIVES: Triple-negative breast cancer (TNBC) is reported to be associated with lower survival and higher incidence rates of early recurrences among younger women, comparing to other types of breast cancer (BC). This impactful disease accounts for considerable healthcare resources utilization (HCRU) and productivity loss costs. In this study, we aimed to determine the economic burden of TNBC in female population in Portugal in 2019, considering direct medical costs and indirect costs regarding labor absenteeism and abandonment of job market.

METHODS: TNBC’s prevalence was calculated using a cumulative incidence model, based on national epidemiological data and publicly available literature. The cost estimation had the prevalence and societal perspective into consideration. An expert panel was conducted to estimate costs related to HCRU and labor absenteeism and abandonment of job market.

RESULTS: Considering a prevalence of 7052 cases in 2019, the total cost associated with TNBC exceeded €50 million, accounting for 16% of all costs estimated for BC, with an average annual cost of €7140 per patient. Its management surpassed €28 million (56%) in direct medical costs, essentially associated with TNBC locoregional stage treatment and follow-up (65%), and €22 million (44%) in indirect costs, almost utterly linked to abandonment of the job market (94%), assuming that 57,8% of prevalent cases were working-aged women. Expenditures seem to vary across cancer stages, with stage IV accounting for 35% of all direct costs (€9,9 million), which is higher than the contribution of stage IV when all BC costs are considered (19%).

CONCLUSIONS: These findings highlight the financial burden attributed to TNBC, when considering advanced stage´s management and treatment. This will set the basis for an accurate assessment of the real burden of TNBC and allow the adoption of effective disease management strategies and health policies, particularly in earlier stages, which can potentially reduce impact to society and Portuguese healthcare system.