Societal and Economic Impact of Targeted Therapy for Breast Cancer in Bulgaria
Author(s)
Anita Tineva, MPH1, Georgi S. Slavchev, PhD2, Ivelina Yankova, BSc1, Veneta Todorova, PhD1, Adriana Dacheva, MA, PhD1, Slaveyko Djambazov, MBA, PhD1.
1HTA Ltd, Sofia, Bulgaria, 2Scientific Director, HTA Ltd., Sofia, Bulgaria.
1HTA Ltd, Sofia, Bulgaria, 2Scientific Director, HTA Ltd., Sofia, Bulgaria.
OBJECTIVES: While targeted therapies have significantly improved outcomes for patients with early and advanced breast cancer, their broader societal and economic impact in Bulgaria has not been sufficiently quantified. This analysis aimed to estimate the health and economic benefits of targeted therapies for breast cancer patients in Bulgaria, focusing on working-age individuals.
METHODS: A partitioned survival model with three health states, a 3.5% annual discount rate, and a lifetime horizon was developed to estimate health gains expressed in quality-adjusted life years (QALYs) for patients treated in stages II-III (early) and stage IV (advanced) breast cancer. The model is transferable and adaptable to countries with similar data availability. According to data from the National Health Insurance Fund (NHIF), the number of patients receiving targeted therapies increased by 141% between 2021 and 2023, reaching 1,360 individuals in 2023.
RESULTS: Based on improved survival and quality of life, the economic contribution to Bulgaria’s gross domestic product (GDP) was estimated for the working-age treated population. The average QALY gain per patient was 9.43 in early-stage disease and 2.93 in advanced-stage disease. Applied to the working-age cohort, the total added GDP contribution was estimated at EUR 40,902,560.
CONCLUSIONS: These findings demonstrate that targeted therapies offer not only substantial clinical benefits but also meaningful economic value to society. Ensuring timely access to personalized treatments should remain a national priority—not only to improve patient outcomes but also to support long-term societal and economic sustainability.
METHODS: A partitioned survival model with three health states, a 3.5% annual discount rate, and a lifetime horizon was developed to estimate health gains expressed in quality-adjusted life years (QALYs) for patients treated in stages II-III (early) and stage IV (advanced) breast cancer. The model is transferable and adaptable to countries with similar data availability. According to data from the National Health Insurance Fund (NHIF), the number of patients receiving targeted therapies increased by 141% between 2021 and 2023, reaching 1,360 individuals in 2023.
RESULTS: Based on improved survival and quality of life, the economic contribution to Bulgaria’s gross domestic product (GDP) was estimated for the working-age treated population. The average QALY gain per patient was 9.43 in early-stage disease and 2.93 in advanced-stage disease. Applied to the working-age cohort, the total added GDP contribution was estimated at EUR 40,902,560.
CONCLUSIONS: These findings demonstrate that targeted therapies offer not only substantial clinical benefits but also meaningful economic value to society. Ensuring timely access to personalized treatments should remain a national priority—not only to improve patient outcomes but also to support long-term societal and economic sustainability.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE661
Topic
Economic Evaluation
Disease
Oncology