OBJECTIVES

To understand current treatment patterns and health care resource utilization (HRU) of women with locally advanced and metastatic breast cancer (ABC) in Taiwan overall and within patients meeting the MONARCH 3 (NCT02246621) clinical trial criteria (postmenopausal women with no prior systemic therapy in the advanced setting).

METHODS

A chart review was conducted in 118 patients: women ≥ 18 years old with hormone receptor positive (HR+)/human epidermal growth receptor-negative (HER2-) ABC diagnosed between 2015 and 2017. Anonymized data on patient characteristics, treatment pathways and HRU was abstracted. Descriptive statistics were used to assess the outcomes.

RESULTS

The mean (range) age of patients was 56.6 (29 - 83) years. Among the 118 patients, the most common first line systemic therapy group after diagnosis of ABC was endocrine-based therapy (39.0%) or endocrine therapy+chemotherapy (ChT) combinations (38.1%). In MONARCH 3 characteristic patients (n=56), endocrine based therapy was most common (44.6%). Oncologist visits, at annual rate of 9.20 (95% CI: 8.81, 9.60), and hospitalizations, at annual rate of 1.08 (95% CI: 0.96, 1.22), and mean (SD) length of stay of 6.95 (6.71) days, were key drivers of health resource utilization. Of the 118 patients, the 72 with at least one chemotherapy agent in their first-line regimen had annual hospitalization rate of 1.4 vs. 0.45 admissions; annual hospital days of 8.5 vs. 5.1; and rate of at least 1 severe adverse (grade 3 or higher) events of 66.7% vs 28.3%, compared to the 46 patients on first-line endocrine based therapy.

CONCLUSIONS

These findings on real world HRU reflected clinical guidelines and severity of ABC. Current treatment pathways suggest an unmet need for new medications that lead to reduction in high rate of chemotherapy use. Results can inform future evaluations of new ABC treatments that estimate the health economic impact of their adoption in Taiwan.