OBJECTIVES: To estimate health care resource use and direct costs by line of treatment related to HR+/HER2− advanced breast cancer in Colombia.

METHODS: A retrospective observational study was conducted analyzing abstracted data from the medical records of women with advanced breast cancer, aged ≥18 years, who initiated first-line treatment during 2012-2014 in Colombia. Healthcare resource use was reported during the first three treatment lines and from discontinuation of the last line of therapy to the end of follow-up. Health care utilization included hospitalizations, emergency department admissions, and physician office visits. Costs were obtained by multiplying mean estimates of resource utilization by unit costs obtained from public and official sources: Price of Medications Information System (SISMED), tariff manuals, or Capitation Payment Unit (UPC) sufficiency study.

RESULTS: A total of 145 patients were included in the study that started first-line and could change to other lines during follow-up (mean, 31.0 [SD 17.8] months). Mean costs (US dollars) per person related to health care visit setting were $2,716, $1,972, and $2,027 during first-, second-, and third-line treatment, respectively. The mean number of visits overall were 28.9 (SD 19). The main cost driver was palliative care visit which were used by three-quarters of patients at least once, representing 68.6% of the total costs. More than one-third of patients had at least one hospitalization during the entire follow-up period (41.0%), which accounted for 20.3% of total cost per patient. The most common reason for hospitalization was surgery (34.7%), followed by management of toxicities/side effects, and disease progression or complications (24.5% each). Hospitalizations had a length of stay with an average of 7.7 (8.1) days.

CONCLUSIONS: Total costs were highest during first-line treatment. Advanced breast cancer patients required substantial palliative care resources and hospitalizations, particularly during first-line treatment.