OBJECTIVES:

To estimate indirect and societal costs for post-menopausal women with HR+/HER2- metastatic breast cancer (mBC) in the United Kingdom (UK), and how disease progression impacts these costs.

METHODS:

We systematically identified studies that assessed the impact of mBC on activities of daily living and lost productivity (ADL/LP). Key ADL/LP categories identified were early mortality, productivity loss, replacement housework, childcare, informal care, lost leisure time, and transportation. UK-specific data were preferred, with data sought from other countries where not available. Costs were estimated in GBP, per woman, per month, for two ‘health states’: stable and progressed disease.

RESULTS:

Of 35 identified studies, three were conducted in the UK and one pan-European. Due to the paucity of UK data, ADL/LP data from other OECD countries were also used. Indirect costs for women with stable HR+/HER2- mBC were calculated at £2,179 per month. Indirect costs in the progressed HR+/HER2- mBC state were calculated as £2,597 (Scenario A) or £2,990 (Scenario B) per month. These scenarios assumed either: (A) ADL/LP was the same in the progressed state and the stable state, if state-specific ADL/LP was not reported; or (B) women in the progressed state suffered a higher ADL/LP impact than in stable disease (by a factor derived from literature and expert opinion). Total indirect costs from metastatic diagnosis to death were £59,819 (Scenario A) or £66,352 (Scenario B) per woman.

CONCLUSIONS:

We estimated that stable disease incurs £418 to £811 less indirect cost per woman per month than progressed disease. To our knowledge, no previous study estimates the progression-related indirect and societal costs of HR+/HER2- mBC in the UK. There is a lack of data regarding the impact of mBC on ADL/LP; more sophisticated data collection is needed to better characterise the financial burden of HR+/HER2- mBC for policy makers, patients and carers.