Costs of Care for Patients With Triple Negative Metastatic Breast Cancer: A Retrospective US Claims Data Study
Moderator
Chintal H Shah, BS, MS, PhD, AstraZeneca, Rockville, MD, United States
Speakers
Simon Collin; Nazneen Fatima Shaikh, BS, PhD, IQVIA, Inc., Harrison, NJ, United States; Jenny Tse, MS, IQVIA, Cambridge, MA, United States; Aimee Near; Tiffany Traina; Manali Bhave
OBJECTIVES: To evaluate costs of care and clinical events of interest (CEIs) among patients with metastatic triple negative breast cancer (mTNBC) who did not receive immunotherapy in a retrospective analysis of US claims data.
METHODS: Patients with ≥1 ICD-10 diagnosis code for breast cancer (BC) and metastasis were identified in IQVIA PharMetrics® Plus claims data from 03/2017-9/2023. Selection criteria included continuous enrollment 6 months before and ≥3 months after index date (earliest metastasis code), BC treatment post-index, no diagnosis codes for other cancers or metastasis within 15 months pre-index, and no HR+ or HER2+ BC treatment (proxy for TNBC) or PD-L1 immunotherapy (atezolizumab/pembrolizumab). All-cause, BC-related, and CEI-related costs per patient per month (PPPM) were reported during overall follow-up and during 1st/2nd line of therapy (1LoT/2LoT). BC-related claims were determined via diagnosis codes or treatments. CEI-related claims, a subset of BC-related claims, included potential adverse effects of BC therapies.
RESULTS: Among treated patients with mTNBC (N=2,717; 99.1% female; mean±SD age, 55.6±10.7 years), prevalent comorbidities included obesity (18.4%), diabetes (8.4%), and chronic pulmonary disease (3.9%). Over follow-up (median [Q1,Q3], 11.7 [6.0,26.5] months), 19.6% of patients reached 2LoT, 4.9% 3LoT; 1LoT and 2LoT were mostly chemotherapy (98.1%, 90.6%). Across any LoT, 76.1% of patients had ≥1 CEI, most commonly hematological (49.5%), gastrointestinal (44.3%), infusion-related reactions (31.2%), and fatigue (27.8%). Time to CEI from LoT initiation was shortest for hematological and gastrointestinal events (median, 14 days). The overall mean±SD all-cause total costs PPPM were $13,873±$12,442 ($17,343±$18,313 during 1LoT, $19,279±$24,285 during 2LoT), of which 79.6% were BC-related and 34.7% were CEI-related. Mean all-cause total costs PPPM were slightly higher among patients with vs. without CEIs within 12 months of LoT initiation ($17,474±$15,838 vs $15,877±15,984).
CONCLUSIONS: In patients with mTNBC, clinical events of interest, particularly gastrointestinal and hematological, were common and represented one-third of costs-of-care.
METHODS: Patients with ≥1 ICD-10 diagnosis code for breast cancer (BC) and metastasis were identified in IQVIA PharMetrics® Plus claims data from 03/2017-9/2023. Selection criteria included continuous enrollment 6 months before and ≥3 months after index date (earliest metastasis code), BC treatment post-index, no diagnosis codes for other cancers or metastasis within 15 months pre-index, and no HR+ or HER2+ BC treatment (proxy for TNBC) or PD-L1 immunotherapy (atezolizumab/pembrolizumab). All-cause, BC-related, and CEI-related costs per patient per month (PPPM) were reported during overall follow-up and during 1st/2nd line of therapy (1LoT/2LoT). BC-related claims were determined via diagnosis codes or treatments. CEI-related claims, a subset of BC-related claims, included potential adverse effects of BC therapies.
RESULTS: Among treated patients with mTNBC (N=2,717; 99.1% female; mean±SD age, 55.6±10.7 years), prevalent comorbidities included obesity (18.4%), diabetes (8.4%), and chronic pulmonary disease (3.9%). Over follow-up (median [Q1,Q3], 11.7 [6.0,26.5] months), 19.6% of patients reached 2LoT, 4.9% 3LoT; 1LoT and 2LoT were mostly chemotherapy (98.1%, 90.6%). Across any LoT, 76.1% of patients had ≥1 CEI, most commonly hematological (49.5%), gastrointestinal (44.3%), infusion-related reactions (31.2%), and fatigue (27.8%). Time to CEI from LoT initiation was shortest for hematological and gastrointestinal events (median, 14 days). The overall mean±SD all-cause total costs PPPM were $13,873±$12,442 ($17,343±$18,313 during 1LoT, $19,279±$24,285 during 2LoT), of which 79.6% were BC-related and 34.7% were CEI-related. Mean all-cause total costs PPPM were slightly higher among patients with vs. without CEIs within 12 months of LoT initiation ($17,474±$15,838 vs $15,877±15,984).
CONCLUSIONS: In patients with mTNBC, clinical events of interest, particularly gastrointestinal and hematological, were common and represented one-third of costs-of-care.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE184
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology