Economic Burden in Metastatic Triple-Negative Breast Cancer (mTNBC): A Systematic Literature Review (SLR)
Author(s)
Yuanhui Zhang, PhD1, Xue Wang, MSPH2, Henry Ogden, PhD3, Marissa Betts, MS4, Manali Ajay Bhave, MD5.
1Gilead Sciences, Inc., Foster City, CA, USA, 2Gilead Sciences, Inc, Foster City, CA, USA, 3Evidera Ltd., London, United Kingdom, 4Evidera Inc., Waltham, MA, USA, 5Winship Cancer Institute, Emory University, Atlanta, GA, USA.
1Gilead Sciences, Inc., Foster City, CA, USA, 2Gilead Sciences, Inc, Foster City, CA, USA, 3Evidera Ltd., London, United Kingdom, 4Evidera Inc., Waltham, MA, USA, 5Winship Cancer Institute, Emory University, Atlanta, GA, USA.
OBJECTIVES: To systematically review the published data on economic burden of mTNBC by programmed death-ligand 1 (PD-L1) status.
METHODS: An SLR following Cochrane methodologies was conducted to evaluate direct and indirect costs and health care resource use. English language studies including patients with TNBC from MEDLINE, Embase, Cochrane Library, CINAHL, and EconLit up to June 2024 were included.
RESULTS: Of 1057 abstracts screened and 61 full texts reviewed, 20 publications from 19 (18 retrospective and 1 prospective) primary observational studies in TNBC with economic outcomes were evaluated. Studies were derived from the United States (US; n = 12), Europe (n = 4) and other (n = 3). Economic data were reported in 10 studies that enrolled patients with mTNBC and in 3 studies that included all TNBC with stage III/IV subgroup analysis. No studies reported economic outcomes stratified by PD-L1 status. Sample sizes ranged from 45 to 3081 patients, with mean ages between 48 and 77 years. Costs were adjusted to 2025. Based on the US studies, per person per month (PPPM) direct medical costs for patients with mTNBC ranged from US$726 to US$57,840, and reflected variation by treatment intensity and proximity to death. Higher total direct costs, hospitalization costs, hospitalization rates, length of stay, emergency department admissions, and specialist visits were seen in patients with advanced stage and later lines of therapy. One US study reported higher workdays lost and disability costs (PPPM) with mTNBC (US$606) compared with locoregional disease (US$480), and no recurrence (US$259), respectively.
CONCLUSIONS: The economic burden of mTNBC is substantial. While direct costs were extensively studied, data on indirect costs were limited, and there were no studies on economic burden by PD-L1 status highlighting an unmet need. The potential role of innovative therapies in reducing economic burden by delaying disease progression also warrants further investigation.
METHODS: An SLR following Cochrane methodologies was conducted to evaluate direct and indirect costs and health care resource use. English language studies including patients with TNBC from MEDLINE, Embase, Cochrane Library, CINAHL, and EconLit up to June 2024 were included.
RESULTS: Of 1057 abstracts screened and 61 full texts reviewed, 20 publications from 19 (18 retrospective and 1 prospective) primary observational studies in TNBC with economic outcomes were evaluated. Studies were derived from the United States (US; n = 12), Europe (n = 4) and other (n = 3). Economic data were reported in 10 studies that enrolled patients with mTNBC and in 3 studies that included all TNBC with stage III/IV subgroup analysis. No studies reported economic outcomes stratified by PD-L1 status. Sample sizes ranged from 45 to 3081 patients, with mean ages between 48 and 77 years. Costs were adjusted to 2025. Based on the US studies, per person per month (PPPM) direct medical costs for patients with mTNBC ranged from US$726 to US$57,840, and reflected variation by treatment intensity and proximity to death. Higher total direct costs, hospitalization costs, hospitalization rates, length of stay, emergency department admissions, and specialist visits were seen in patients with advanced stage and later lines of therapy. One US study reported higher workdays lost and disability costs (PPPM) with mTNBC (US$606) compared with locoregional disease (US$480), and no recurrence (US$259), respectively.
CONCLUSIONS: The economic burden of mTNBC is substantial. While direct costs were extensively studied, data on indirect costs were limited, and there were no studies on economic burden by PD-L1 status highlighting an unmet need. The potential role of innovative therapies in reducing economic burden by delaying disease progression also warrants further investigation.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE356
Topic
Economic Evaluation
Topic Subcategory
Trial-Based Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology