Breast Cancer and Its Organ-Specific Metastatic Cascade: Pathological Insights and Pharmacoeconomic Implications for Targeted Therapeutics
Author(s)
JAI D. TELLA, Jr., PharmD.
ASSISTANT PROFESSOR, CHALAPATHI INSTITUTE OF PHARMACEUTICAL SCIENCES, GUNTUR, India.
ASSISTANT PROFESSOR, CHALAPATHI INSTITUTE OF PHARMACEUTICAL SCIENCES, GUNTUR, India.
OBJECTIVES: To investigate the pathological characteristics and metastatic distribution of breast cancer subtypes, and to examine the pharmacoeconomic implications of targeted medicines used to treat organ-specific metastases.
METHODS: A retrospective cohort analysis was performed on 427 patients diagnosed with Stage III-IV breast cancer between 2018 and 2024 at three tertiary hospitals in South India. Data on demographics, molecular subtype, metastatic site, pathology reports, treatment regimen, and direct healthcare costs were gathered. Cost-effectiveness was assessed using Quality-Adjusted Life Years (QALYs) and the Incremental Cost-Effectiveness Ratio (ICER). Statistical analysis used chi-square tests, ANOVA, and logistic regression (p < 0.05).
RESULTS: The most common metastatic site was bone (45.7%), followed by the liver (26.1%), lungs (18.3%), and brain (9.9%). HER2-positive subtypes were substantially associated with brain metastases (p=0.001), whereas TNBC was associated with lung involvement (p=0.007). In HER2-positive patients, targeted therapy costs an average of ₹5.42 lakh, whereas standard chemotherapy costs ₹1.97 lakh. T-DM1 had an ICER of ₹2.11 lakh/QALY, meeting WHO-CHOICE cost-effectiveness limits in India.
CONCLUSIONS: The study emphasises the importance of striking a balance between clinical benefit and economic sustainability in metastatic breast cancer management. Treatment stratification based on metastatic site and molecular subtype, as well as pharmacoeconomic assessment, can help to promote sustainable and fair oncology practices.
METHODS: A retrospective cohort analysis was performed on 427 patients diagnosed with Stage III-IV breast cancer between 2018 and 2024 at three tertiary hospitals in South India. Data on demographics, molecular subtype, metastatic site, pathology reports, treatment regimen, and direct healthcare costs were gathered. Cost-effectiveness was assessed using Quality-Adjusted Life Years (QALYs) and the Incremental Cost-Effectiveness Ratio (ICER). Statistical analysis used chi-square tests, ANOVA, and logistic regression (p < 0.05).
RESULTS: The most common metastatic site was bone (45.7%), followed by the liver (26.1%), lungs (18.3%), and brain (9.9%). HER2-positive subtypes were substantially associated with brain metastases (p=0.001), whereas TNBC was associated with lung involvement (p=0.007). In HER2-positive patients, targeted therapy costs an average of ₹5.42 lakh, whereas standard chemotherapy costs ₹1.97 lakh. T-DM1 had an ICER of ₹2.11 lakh/QALY, meeting WHO-CHOICE cost-effectiveness limits in India.
CONCLUSIONS: The study emphasises the importance of striking a balance between clinical benefit and economic sustainability in metastatic breast cancer management. Treatment stratification based on metastatic site and molecular subtype, as well as pharmacoeconomic assessment, can help to promote sustainable and fair oncology practices.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH28
Topic
Epidemiology & Public Health, Health Service Delivery & Process of Care, Patient-Centered Research
Disease
Oncology