THE ECONOMIC BURDEN OF EARLY-STAGE HR+/HER2- BREAST CANCER (BC) IN SPAIN: A COST-OF-ILLNESS STUDY
Author(s)
José Ángel García Sáenz, PhD1, Joaquín Gavilá, PhD2, María Vidal, PhD3, CARLES BLANCH MUR, MD4, Estefany Uría, BSc5, Laura Ricou, MSc5, Rosa Palomino, MSc5.
1Hospital Clínico San Carlos, Madrid, Spain, 2Fundación Instituto Valenciano de Oncología, Valencia, Spain, 3Hospital Clínic de Barcelona, Barcelona, Spain, 4NOVARTIS FARMACEUTICA, BARCELONA, Spain, 5Cencora Spain, Barcelona, Spain.
1Hospital Clínico San Carlos, Madrid, Spain, 2Fundación Instituto Valenciano de Oncología, Valencia, Spain, 3Hospital Clínic de Barcelona, Barcelona, Spain, 4NOVARTIS FARMACEUTICA, BARCELONA, Spain, 5Cencora Spain, Barcelona, Spain.
OBJECTIVES: To estimate the burden of early-stage HR+/HER2− BC in Spain using a pharmacoeconomic model informed by a Delphi panel of Spanish clinical experts.
METHODS: An incidence-based cost-of-illness model reflecting the natural history of disease and structured into clinically relevant health states was developed, considering a cohort of patients newly diagnosed with early-stage (I-III) HR+/HER2− BC in Spain over a one-year period. The model stratified patients by stage at diagnosis and followed them over a 10-year horizon from the Spanish National Health System (NHS) perspective. Resource use data were collected through a physician Delphi panel conducted with 6 clinical experts in Spain. Direct healthcare costs (diagnosis, treatment, follow-up, recurrence, and palliative care) were estimated by multiplying unit costs from Spanish databases, and resource utilization (€2026).
RESULTS: The incident cohort was estimated to be 25,806 patients with early-stage HR+/HER2− BC (I: 12,801; II: 9,214; III: 3,794). At year 10, 79%, 71%, and 62% of patients remained in the invasive disease-free state for stages I, II, and III, respectively. By the end of follow-up, 12% (stage I), 22% (stage II), and 30% (stage III) experienced locoregional or metastatic recurrence. Mean per-patient costs increased with disease stage: €36,671 (I), €50,787 (II), and €68,175 (III). Across all stages, the main drivers were post-surgical treatment (32%-40% of total costs) and metastatic recurrence (34%-36%). Costs were concentrated in the first two years following diagnosis, accounting for 50% of total costs in stage I, 54% (stage II), and 62% (stage III). Total cohort-level costs were higher for stage I (€469.4M) than II (€467.9M) and III (€258.7M) due to more patients diagnosed at earlier stages.
CONCLUSIONS: Early-stage HR+/HER2− BC imposes a considerable economic burden on the Spanish NHS, driven by disease stage and recurrence. Interventions that delay or prevent progression to advanced disease may reduce long-term costs and improve resource allocation.
METHODS: An incidence-based cost-of-illness model reflecting the natural history of disease and structured into clinically relevant health states was developed, considering a cohort of patients newly diagnosed with early-stage (I-III) HR+/HER2− BC in Spain over a one-year period. The model stratified patients by stage at diagnosis and followed them over a 10-year horizon from the Spanish National Health System (NHS) perspective. Resource use data were collected through a physician Delphi panel conducted with 6 clinical experts in Spain. Direct healthcare costs (diagnosis, treatment, follow-up, recurrence, and palliative care) were estimated by multiplying unit costs from Spanish databases, and resource utilization (€2026).
RESULTS: The incident cohort was estimated to be 25,806 patients with early-stage HR+/HER2− BC (I: 12,801; II: 9,214; III: 3,794). At year 10, 79%, 71%, and 62% of patients remained in the invasive disease-free state for stages I, II, and III, respectively. By the end of follow-up, 12% (stage I), 22% (stage II), and 30% (stage III) experienced locoregional or metastatic recurrence. Mean per-patient costs increased with disease stage: €36,671 (I), €50,787 (II), and €68,175 (III). Across all stages, the main drivers were post-surgical treatment (32%-40% of total costs) and metastatic recurrence (34%-36%). Costs were concentrated in the first two years following diagnosis, accounting for 50% of total costs in stage I, 54% (stage II), and 62% (stage III). Total cohort-level costs were higher for stage I (€469.4M) than II (€467.9M) and III (€258.7M) due to more patients diagnosed at earlier stages.
CONCLUSIONS: Early-stage HR+/HER2− BC imposes a considerable economic burden on the Spanish NHS, driven by disease stage and recurrence. Interventions that delay or prevent progression to advanced disease may reduce long-term costs and improve resource allocation.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE520
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Oncology