Healthcare Utilization Patterns in Early-Stage Breast Cancer Taiwanese Patients: A Real World Evidence-Based Subtype-Specific Study
Author(s)
Hsu-Huan Chou, MD1, Yu-Chen Kuo, MS2, Hazel Huang, MS2, Huey-Chwen Lin, MPH2, Fatima M. Nathan, PhD3, Mark Sales, BSc4.
1Chang Gung Memorial Hospital, Taoyuan, Taiwan, 2Oracle Life Sciences, Taipei, Taiwan, 3Research Consultant, Oracle Life Sciences, Singapore, Singapore, 4Global Director of Commercial Research Strategy, Oracle Life Sciences, Reading, United Kingdom.
1Chang Gung Memorial Hospital, Taoyuan, Taiwan, 2Oracle Life Sciences, Taipei, Taiwan, 3Research Consultant, Oracle Life Sciences, Singapore, Singapore, 4Global Director of Commercial Research Strategy, Oracle Life Sciences, Reading, United Kingdom.
Presentation Documents
OBJECTIVES: Despite improved survival from advances in early-stage human epidermal growth factor receptor 2 (HER2)-targeted therapies, certain breast cancer molecular subtypes, such as triple-negative breast cancer (TNBC) remain challenging to manage. This study examined healthcare utilisation (HCU) patterns among breast cancer subtypes in Taiwan.
METHODS: This retrospective longitudinal study used data from the Linkou Chang Gung Memorial Hospital Database (2018-2021). Newly diagnosed, early-stage HER2+, HR+/HER2- and TNBC breast cancer patients with ≥3 years data were included. Outpatient, hospitalisation, and emergency room (ER) visits were used to evaluate HCU. Descriptive analyses were used to report patient demographics and HCU across different subtypes and generalised estimating equations for associations between patient characteristics and HCU.
RESULTS: Among 1,698 patients, most were HR+/HER2-(68.5%), aged 53.6±11.2 (mean±standard deviation), diagnosed at stage II (54.8%). Chemotherapy and hormone therapy was most common [34.7%; HER2+ (7.3%), HR+/HER2-(47.6%), TNBC (4.3%)]. Majority had >30 outpatient visits, with most in the first year (Y1; HER2-/HR+: 17.7 and HER 2+:21.1 and TNBC: 21.2 times). Over 80.0% of patients required 8.4 times of hospitalisations, decreasing over time. TNBC patients recorded the longest hospitalisation (27.7 days) in third year, with the highest ER visits in Y1 (27.1%). Chemotherapy, targeted therapy ± hormonal therapy (HT) increased the likelihood of outpatient (+HT; adjusted odds ratio, aOR:1.76; -HT, aOR:1.87) and inpatient (+HT, aOR:4.70, -HT, aOR:4.85) utilisation (p<0.0001). Neoadjuvant treatment increased hospitalisation odds (aOR:1.46) and doubled the likelihood of length of stay (aOR:2.24) (p<0.001); while pathological complete response had half the odds with increased length of stay (aOR:0.56; p<0.001).
CONCLUSIONS: The findings showed HCU peaked within first year of diagnosis, with TNBC patients requiring higher late-term healthcare needs. These findings underscore the importance of subtype-specific survivorship planning and resource allocation to optimise outcomes and decrease the associated economic burden.
METHODS: This retrospective longitudinal study used data from the Linkou Chang Gung Memorial Hospital Database (2018-2021). Newly diagnosed, early-stage HER2+, HR+/HER2- and TNBC breast cancer patients with ≥3 years data were included. Outpatient, hospitalisation, and emergency room (ER) visits were used to evaluate HCU. Descriptive analyses were used to report patient demographics and HCU across different subtypes and generalised estimating equations for associations between patient characteristics and HCU.
RESULTS: Among 1,698 patients, most were HR+/HER2-(68.5%), aged 53.6±11.2 (mean±standard deviation), diagnosed at stage II (54.8%). Chemotherapy and hormone therapy was most common [34.7%; HER2+ (7.3%), HR+/HER2-(47.6%), TNBC (4.3%)]. Majority had >30 outpatient visits, with most in the first year (Y1; HER2-/HR+: 17.7 and HER 2+:21.1 and TNBC: 21.2 times). Over 80.0% of patients required 8.4 times of hospitalisations, decreasing over time. TNBC patients recorded the longest hospitalisation (27.7 days) in third year, with the highest ER visits in Y1 (27.1%). Chemotherapy, targeted therapy ± hormonal therapy (HT) increased the likelihood of outpatient (+HT; adjusted odds ratio, aOR:1.76; -HT, aOR:1.87) and inpatient (+HT, aOR:4.70, -HT, aOR:4.85) utilisation (p<0.0001). Neoadjuvant treatment increased hospitalisation odds (aOR:1.46) and doubled the likelihood of length of stay (aOR:2.24) (p<0.001); while pathological complete response had half the odds with increased length of stay (aOR:0.56; p<0.001).
CONCLUSIONS: The findings showed HCU peaked within first year of diagnosis, with TNBC patients requiring higher late-term healthcare needs. These findings underscore the importance of subtype-specific survivorship planning and resource allocation to optimise outcomes and decrease the associated economic burden.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD77
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Oncology