OBJECTIVES : To estimate the disease burden of breast cancer (BC) under the current treatment pattern in China.

METHODS : A decision-analytic model was constructed to simulate the Chinese patients with BC and the age and gender-matched Chinese general population over lifetime time horizon for the differences in overall survival, quality-adjusted life years (QALY), and lifetime direct medical costs. A literature search was conducted to estimate the model variables. Base case analysis and sensitivity analysis were conducted for the point estimations and uncertainty of the disease burden of BC.

RESULTS : The Chinese BC patients were associated with reduced average overall survival by 7.054 years (20.933 years vs. 27.987 years), reduced average QALY by 9.651 QALY (14.727 QALY vs. 24.378 QALY), and increased average lifetime direct medical costs by ¥534,867 (¥692,056 vs. ¥157,189). The reduced QALY associated with BC was sensitive to utility of stage I (change: 0.482 QALY) and stage II BC (change: 0.947 QALY), risk of disease recurrence after radical mastectomy (change: -0.886 QALY), proportions of stage I (change: 0.870 QALY) and stage IV BC at diagnosis (change: -0.857 QALY). The increased lifetime direct medical costs associated with BC was sensitive to medical costs of progressive disease (change: ¥172,362), treatment response to exemestane (change: ¥-91,035), and the mortality of progressive disease (change: ¥-51,827). The probabilistic sensitivity analysis with 5,000 Monte Carlo simulations estimated the median and 95% credible interval of reduced QALY (-9.881 QALY; -11.306 to -8.386 QALY ) and increased lifetime direct medical costs (¥548,992, ¥464,895 to ¥650,181).

CONCLUSIONS : The disease burden of BC in Chinese patients was characterized by reduced overall survival, reduced QALY, and increased medical costs that were sensitive to disease stage distribution at diagnosis, utility of early-stage BC, exemestane treatment, and the mortality and medical costs of progressive disease.