Presentation (CTI)

OBJECTIVES: While targeted therapies have improved outcomes for patients with breast cancer, their broader societal and economic impact remains insufficiently quantified in Bulgaria. Earlier treatment initiation may generate greater health gains than treatment in metastatic disease and may preserve productivity among patients of working age.
METHODS: To address this, a health-economic model with a lifetime horizon and 3.5% annual discounting was developed to estimate health gains from targeted therapies, expressed as quality-adjusted life years (QALYs), in patients treated in the adjuvant/neoadjuvant and metastatic breast cancer settings. Only discounted outcomes were reported. The economic contribution was estimated by translating health gains into gross domestic product (GDP) contribution for the working-age treated population.
RESULTS: The model included 3,560 patients receiving targeted therapy, of whom 730 were treated in the adjuvant/neoadjuvant setting and 2,830 in the metastatic setting. Discounted QALYs per patient were 12.13 in the adjuvant/neoadjuvant setting compared with 3.99 in metastatic disease. Therefore, initiating treatment earlier generated an incremental discounted gain of 8.13 QALYs per patient, corresponding to an estimated EUR 322,095 additional GDP contribution per working-age patient with breast cancer. Overall, targeted therapy generated 8,852 discounted QALYs in the adjuvant/neoadjuvant setting and 11,299 discounted QALYs in metastatic disease. Across the total treated population, this corresponded to a weighted average of 5.66 discounted QALYs per patient and an estimated GDP contribution of EUR 103,382,663.18 among patients of working age.
CONCLUSIONS: These findings demonstrate that earlier targeted therapy initiation provides substantial incremental health and macroeconomic value. Timely diagnosis and rapid access to personalized treatment should remain a healthcare priority in Bulgaria.