Comparing Countries’ Time to Treatment Initiation: A Study of Metastatic Breast Cancer in Austria and the United States
Author(s)
Harlan Pittell, PhD1, Mohamed S. Ali, PharmD, SM2, Philani Mpofu, PhD2, Elsie Horne, PhD3, Per-Olof Thuresson, MSc, PharmD4, Xiaolong Jiao, MS, MD5, Stella Mokiou, BSc, MSc, PhD6, Qianyi Zhang, MS7, Amit Samani, PhD, MD8, Blythe Adamson, MPH, PhD2.
1Senior Research Scientist, Flatiron Health, New York, NY, USA, 2Flatiron Health, New York, NY, USA, 3Flatiron Health UK, London, United Kingdom, 4Roche Products Ltd, Basel, Switzerland, 5Pfizer, Wynnewood, PA, USA, 6Pfizer, REDHILL, United Kingdom, 7Flatiron Health Inc, Jersey City, NJ, USA, 8Flatiron Health, London, United Kingdom.
1Senior Research Scientist, Flatiron Health, New York, NY, USA, 2Flatiron Health, New York, NY, USA, 3Flatiron Health UK, London, United Kingdom, 4Roche Products Ltd, Basel, Switzerland, 5Pfizer, Wynnewood, PA, USA, 6Pfizer, REDHILL, United Kingdom, 7Flatiron Health Inc, Jersey City, NJ, USA, 8Flatiron Health, London, United Kingdom.
OBJECTIVES: Timely initiation of first-line (1L) therapy following metastatic breast cancer (mBC) diagnosis can improve survival outcomes for patients. Differences in healthcare systems and care delivery between countries may influence timeliness of treatment start. This study compared time from mBC diagnosis to 1L initiation in Austria and the US, using high-quality real-world data (RWD).
METHODS: We conducted a retrospective cohort study using RWD from the Austrian AGMT registry and the US Flatiron Health Research Database. Adult patients diagnosed with mBC from January 2015 to September 2024, with follow-up through December 2024 were included. The primary outcome was time from metastatic diagnosis to 1L treatment initiation, reported as median days (interquartile range [IQR]), overall and by molecular subtype.
RESULTS: The study included 1,292 patients in Austria and 21,215 patients in the US. Median time to treatment was 21 days (IQR: 10-35) in Austria and 18 days (IQR: 7-35) in the US. By molecular subtype: HR+/HER2+, median was 20 days (IQR: 13-35) in Austria and 19 days (IQR: 4-35) in the US; HR+/HER2-, 21 days (IQR: 10-35) in Austria and 16 days (IQR: 6-32) in the US; HR-/HER2+, 14 days (IQR: 8-32) in Austria and 27 days (IQR: 15-41) in the US; HR-/HER2-, 25 days (IQR: 12-42) in Austria and 27 days (IQR: 14-42) in the US.
CONCLUSIONS: This study examines treatment patterns in mBC care using two real-world data sources from distinct national contexts - one representing academic settings and the other a mix of academic and community-based practices. Overall time from mBC diagnosis to 1L initiation was similar between the Austria and US cohorts, while some numerical variation was observed by molecular subtype. Potential impacts on outcomes should be assessed together with other covariates, and limited sample sizes in the Austrian cohort underscore the need for further research to validate these findings.
METHODS: We conducted a retrospective cohort study using RWD from the Austrian AGMT registry and the US Flatiron Health Research Database. Adult patients diagnosed with mBC from January 2015 to September 2024, with follow-up through December 2024 were included. The primary outcome was time from metastatic diagnosis to 1L treatment initiation, reported as median days (interquartile range [IQR]), overall and by molecular subtype.
RESULTS: The study included 1,292 patients in Austria and 21,215 patients in the US. Median time to treatment was 21 days (IQR: 10-35) in Austria and 18 days (IQR: 7-35) in the US. By molecular subtype: HR+/HER2+, median was 20 days (IQR: 13-35) in Austria and 19 days (IQR: 4-35) in the US; HR+/HER2-, 21 days (IQR: 10-35) in Austria and 16 days (IQR: 6-32) in the US; HR-/HER2+, 14 days (IQR: 8-32) in Austria and 27 days (IQR: 15-41) in the US; HR-/HER2-, 25 days (IQR: 12-42) in Austria and 27 days (IQR: 14-42) in the US.
CONCLUSIONS: This study examines treatment patterns in mBC care using two real-world data sources from distinct national contexts - one representing academic settings and the other a mix of academic and community-based practices. Overall time from mBC diagnosis to 1L initiation was similar between the Austria and US cohorts, while some numerical variation was observed by molecular subtype. Potential impacts on outcomes should be assessed together with other covariates, and limited sample sizes in the Austrian cohort underscore the need for further research to validate these findings.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD26
Topic
Health Service Delivery & Process of Care
Disease
Oncology