INCREASED HEALTHCARE COSTS AND RESOURCE UTILIZATION FOLLOWING PROGRESSION IN PATIENTS WITH HR+/HER2- METASTATIC BREAST CANCER RECEIVING CHEMOTHERAPY
Author(s)
Tiffany A. Traina, MD1, Carmine Rossi, PhD2, Mohira Levesque-Leroux, MSc2, Claire Vanden Eynde, MSc2, Patrick Gagnon-Sanschagrin, MSc2, Annie Guerin, MSc2, Silke Guenther, Dr. med.3, Victoria Guan, PharmaD4, Jonathan Salcedo, PhD4;
1Memorial Sloan Kettering Cancer Center, New York, NY, USA, 2Analysis Group ULC, Montréal, QC, Canada, 3BioNTech SE, Mainz, Germany, 4BioNTech US Inc, Cambridge, MA, USA
1Memorial Sloan Kettering Cancer Center, New York, NY, USA, 2Analysis Group ULC, Montréal, QC, Canada, 3BioNTech SE, Mainz, Germany, 4BioNTech US Inc, Cambridge, MA, USA
OBJECTIVES: Quantify healthcare costs and healthcare resource utilization (HCRU) around progression among patients with HR+/HER2- (HER2 IHC0 and HER2-low) metastatic breast cancer (mBC) treated with chemotherapy following endocrine therapy (ET)-based treatment or with primary endocrine resistance.
METHODS: Adult patients with HR+/HER2- (inferred from treatments received) mBC who initiated chemotherapy between 1/1/2017-7/31/2024 after ≥2 prior lines of ET-based treatment or within 6 months of starting first-line ET + CDK4/6i (primary endocrine resistance) were identified in the Komodo Research Database (KRD+; 1/1/2016-1/31/2025). Costs (adjusted to 2025 USD) and HCRU were measured from chemotherapy initiation to end of follow-up. Among patients with a non-death progression event on chemotherapy (defined with medical expert guidance as hospice admission, subsequent therapy or radiotherapy initiation), costs and HCRU were compared between the pre-progression and post-progression periods using paired t-tests.
RESULTS: 1,598 patients receiving chemotherapy for HR+/HER2- mBC were included. Median age at chemotherapy initiation was 59.0 years, 72.5% were White and 66.5% were commercially insured. Over a median follow-up of 11.0 months, patients (n=1,598) incurred mean total healthcare (medical + pharmacy) costs of $17,502 per-patient-per-month (PPPM). Of the 1,130 patients with a non-death progression, mean costs were significantly higher post-progression PPPM ($23,985 vs. $15,205; p<0.001), predominantly driven by an increase in BC treatment-related costs ($6,525 vs. $3,810 PPPM; p<0.001) and non-BC-treatment-related medical costs ($16,341 vs. $10,948 PPPM; p<0.001). Mean PPPM HCRU was also higher post-progression, particularly for the number of all-cause inpatient days (2.2 vs. 0.7; p<0.001) and number of all-cause outpatient visits (6.5 vs. 6.1; p<0.05).
CONCLUSIONS: These findings indicate that patients with HR+/HER2- (HER2 IHC0 and HER2-low) mBC treated with chemotherapy incur substantial costs and HCRU, driven largely by non-BC-treatment-related medical costs, particularly following progression. These findings fill an evidence gap and underscore the need for therapies that delay progression and reduce the associated economic burden.
METHODS: Adult patients with HR+/HER2- (inferred from treatments received) mBC who initiated chemotherapy between 1/1/2017-7/31/2024 after ≥2 prior lines of ET-based treatment or within 6 months of starting first-line ET + CDK4/6i (primary endocrine resistance) were identified in the Komodo Research Database (KRD+; 1/1/2016-1/31/2025). Costs (adjusted to 2025 USD) and HCRU were measured from chemotherapy initiation to end of follow-up. Among patients with a non-death progression event on chemotherapy (defined with medical expert guidance as hospice admission, subsequent therapy or radiotherapy initiation), costs and HCRU were compared between the pre-progression and post-progression periods using paired t-tests.
RESULTS: 1,598 patients receiving chemotherapy for HR+/HER2- mBC were included. Median age at chemotherapy initiation was 59.0 years, 72.5% were White and 66.5% were commercially insured. Over a median follow-up of 11.0 months, patients (n=1,598) incurred mean total healthcare (medical + pharmacy) costs of $17,502 per-patient-per-month (PPPM). Of the 1,130 patients with a non-death progression, mean costs were significantly higher post-progression PPPM ($23,985 vs. $15,205; p<0.001), predominantly driven by an increase in BC treatment-related costs ($6,525 vs. $3,810 PPPM; p<0.001) and non-BC-treatment-related medical costs ($16,341 vs. $10,948 PPPM; p<0.001). Mean PPPM HCRU was also higher post-progression, particularly for the number of all-cause inpatient days (2.2 vs. 0.7; p<0.001) and number of all-cause outpatient visits (6.5 vs. 6.1; p<0.05).
CONCLUSIONS: These findings indicate that patients with HR+/HER2- (HER2 IHC0 and HER2-low) mBC treated with chemotherapy incur substantial costs and HCRU, driven largely by non-BC-treatment-related medical costs, particularly following progression. These findings fill an evidence gap and underscore the need for therapies that delay progression and reduce the associated economic burden.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE258
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology