Costs of Care for Patients With Triple Negative Metastatic Breast Cancer: A Retrospective US Claims Data Study
Author(s)
Simon Collin, PhD1, Nazneen Fatima Shaikh, PhD2, Jenny Tse, MS2, Aimee Near, MPH2, Chintal H. Shah, PhD3, Tiffany Traina, MD4, Manali Bhave, MD5.
1Oncology Outcomes Research, AstraZeneca Pharmaceuticals Ltd., Cambridge, United Kingdom, 2Real World Solutions, IQVIA, Inc., Durham, NC, USA, 3Oncology Outcomes Research, AstraZeneca Pharmaceuticals LP., Gaithersburg, MD, USA, 4Memorial Sloan Kettering Cancer Center, New York, NY, USA, 5Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA.
1Oncology Outcomes Research, AstraZeneca Pharmaceuticals Ltd., Cambridge, United Kingdom, 2Real World Solutions, IQVIA, Inc., Durham, NC, USA, 3Oncology Outcomes Research, AstraZeneca Pharmaceuticals LP., Gaithersburg, MD, USA, 4Memorial Sloan Kettering Cancer Center, New York, NY, USA, 5Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA.
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