Real-World Telehealth Utilization and Healthcare Costs in Commercially Insured Women With Breast Cancer: A Claims-Based Study
Author(s)
Shaimaa Elshafie, BPharm, MSc, Lorenzo Villa Zapata, PharmD, PhD;
College of Pharmacy, University of Georgia, Clinical and Administrative Pharmacy, Athens, GA, USA
College of Pharmacy, University of Georgia, Clinical and Administrative Pharmacy, Athens, GA, USA
Presentation Documents
OBJECTIVES: Telehealth platforms have become integral to patient care, especially since the onset of the COVID-19 pandemic and their expanded availability. This study examined telehealth utilization patterns and associated healthcare costs in young women with nonmetastatic breast cancer.
METHODS: This retrospective analysis used the 2017-2023 Merative MarketScan Commercial Encounters database. Eligible patients were women under 65 years old who were diagnosed with nonmetastatic breast cancer and maintained continuous insurance enrollment for at least one year before diagnosis and five years post endocrine therapy initiation. Telehealth usage and healthcare costs were assessed from treatment index through a five-year follow-up period. Statistical analyses were conducted using SAS software (version 9.4 TS1M6) with significance set at p ≤ 0.05.
RESULTS: The cohort included 1,173 patients with a mean age of 51 years. Over five years, 901 patients (77%) utilized telehealth services accounting for more than 8,700 visits. Telehealth use was consistent across age groups and insurance plan types but varied significantly by region with the highest usage rates in the West (86%). Urban residents were more likely to use telehealth compared to rural residents (79% vs. 68%). Telehealth utilization was also more common among patients with higher comorbidity scores and those who switched endocrine therapies (83%) compared to users of tamoxifen (74%) or aromatase inhibitors (73%) (p < 0.05). Total medical expenditures exceeded $8.8 million averaging $7,576 per patient, while prescription costs totaled over $2.1 million averaging $1,861 per patient. Telehealth users incurred higher out-of-pocket costs for both medical care and prescriptions than nonusers.
CONCLUSIONS: Telehealth utilization among young breast cancer patients varied by geographic, clinical, and treatment-related factors during the pandemic. The financial burden of telehealth adoption highlights the need for further evaluation to ensure equitable access and affordability.
METHODS: This retrospective analysis used the 2017-2023 Merative MarketScan Commercial Encounters database. Eligible patients were women under 65 years old who were diagnosed with nonmetastatic breast cancer and maintained continuous insurance enrollment for at least one year before diagnosis and five years post endocrine therapy initiation. Telehealth usage and healthcare costs were assessed from treatment index through a five-year follow-up period. Statistical analyses were conducted using SAS software (version 9.4 TS1M6) with significance set at p ≤ 0.05.
RESULTS: The cohort included 1,173 patients with a mean age of 51 years. Over five years, 901 patients (77%) utilized telehealth services accounting for more than 8,700 visits. Telehealth use was consistent across age groups and insurance plan types but varied significantly by region with the highest usage rates in the West (86%). Urban residents were more likely to use telehealth compared to rural residents (79% vs. 68%). Telehealth utilization was also more common among patients with higher comorbidity scores and those who switched endocrine therapies (83%) compared to users of tamoxifen (74%) or aromatase inhibitors (73%) (p < 0.05). Total medical expenditures exceeded $8.8 million averaging $7,576 per patient, while prescription costs totaled over $2.1 million averaging $1,861 per patient. Telehealth users incurred higher out-of-pocket costs for both medical care and prescriptions than nonusers.
CONCLUSIONS: Telehealth utilization among young breast cancer patients varied by geographic, clinical, and treatment-related factors during the pandemic. The financial burden of telehealth adoption highlights the need for further evaluation to ensure equitable access and affordability.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE277
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology