OBJECTIVES:

Evidence on clinical outcomes and healthcare resource utilization (HRU) among triple-negative breast cancer (TNBC) patients in Thailand has been very limited. Therefore, this study aims to evaluate health outcomes, prognostic factors, and HRU using electronic health records (EHR) among Thai TNBC patients.

METHODS:

About 143,053 EHR during 2005-2018 were retrospectively obtained from a tertiary hospital. Data included patient’s characteristics, diagnosis, laboratory test, medication used, healthcare cost, length of stay, and clinical outcomes. All costs were adjusted to the 2018 value and converted to US dollars ($) using an exchange rate of 30.35 Thai baht. Non-parametric tests were applied to compare healthcare costs between TNBC and non-TNBC groups.

RESULTS:

Among 5,712 breast cancer patients, about 0.68% were diagnosed with TNBC and 60.1% were metastatic TNBC. The median age at diagnosis of TNBC patients was 51.7 (interquartile range, 44.9-60.7) years and a median follow-up time was 144.9 months. Median survival time of TNBC cohort was 12.4 (95%CI 8.1-21.3) months and there was no significant prognostic factor on this outcome. For outpatient visit of TNBC group, mean annual number of visits (SD), annual treatment cost, and lifetime cost were 4.6 (5.2) times, $2,478 ($7,376), and $4,191 ($10,750), respectively. For inpatient visit of TNBC group, mean annual number of visits, length of stay, annual treatment cost, and lifetime cost were 2.3 (2.1) times, 7.0 (8.2) days, $2,481 ($2,366), and $3,125 ($2,960), respectively. Mean lifetime cost of TNBC group ($4,191) was significantly lower than non-TNBC group ($23,085), which drug costs accounted for 76% and 87%, respectively.

CONCLUSIONS:

This study highlights the poor outcome and the high burden of TNBC patients in Thailand. Compared to non-TNBC group, a lower lifetime cost in TNBC group might result from the lower drug expenditure. Strategies to improve efficiency of TNBC treatments and clinical outcomes should be further explored.