OBJECTIVES: HER2+ breast cancer (BC) is a major health concern in Panama, with 1,482 new cases reported in 2020, representing 32.5% of female cancers. This study aims to estimate the economic burden of this type of cancer and analyze the epidemiological and cost impact of HER2+ targeted therapies.

METHODS: A Panel Delphi, bottom-up cost analysis was conducted with the oncologic team of Hospital Anita Moreno (oncologist, nurses & pharmacists) from Panama, to determine the real-world HER2+ breast cancer patient management. These experts evaluate the probability and frequency of resource usage, to determine the difference within management and healthcare systems. The HER2+ BC management costs (USD2024) were obtained by public purchase story, tariff manuals and reported by experts. Also, a population estimation model was performed to determine the impact of targeted HER2+ therapies in early BC avoided relapses, prevented metastases, life years (LYs) gained, quality-adjusted life years (QALYs), and metastatic BC cost reduction, comparing a base scenario (chemotherapy alone) vs actual scenario (Chemotherapy, Trastuzumab & Pertuzumab+Trastuzumab in Neoadjuvant only) vs ideal one (Chemotherapy, Trastuzumab, Pertuzumab & Trastuzumab+Emtansine).

RESULTS: The average-annual-cost of healthcare for a patient with HER2+ BC (actual scenario) in neoadyuvance, adyuvance and metastases in 1st & 2nd line are USD52,732.48; USD30,247.01, USD46,457.88, USD144,599.42; respectively. The disease-targeted therapies in the actual and ideal scenario for Hospital Anita Moreno in 2024 vs chemotherapy alone impact respectively, 3 & 5 recurrences avoided, 3 & 5 metastases prevented, 97 & 143 LYs gained, 76 & 112 QALYs gained, and USD605,738 & USD890,072 saved.

CONCLUSIONS:

The treatment of HER2+ BC in Hospital Anita Moreno in Panamá is more expensive in the metastatic stages than in neo-adyuvance or adyuvance stages, the use of targeted therapies helps to improve patient’s health, avoid metastases, gain LYs & QALYs, and save money from the metastases avoided.