INCIDENCE, PRESCRIPTION PATTERNS, DISEASE PROGRESSION AND COSTS OF STAGE IV HR+/HER2- METASTATIC BREAST CANCER- A REAL-WORLD ANALYSIS OF A LARGE ITALIAN DATABASE

Author(s)

Piccinni C, Ronconi G, Calabria S, Dondi L, Forcesi E, Pedrini A, Martini N, Marangolo M
Fondazione ReS (Ricerca e Salute) – CINECA partner, Roma, Italy

OBJECTIVES: To provide the burden of stage IV HR+/HER2- metastatic breast cancer in Italy, in terms of incidence, prescription patterns, disease progression, healthcare resource utilization and costs for National Health System (NHS).

METHODS: A cohort study based on healthcare administrative data collected in ARCO database, covering >10 millions of Italians, was performed. Incident cases of stage IV HR+/HER2- metastatic breast cancer were identified among adult women, at 2013, by applying a specific algorithm. The cohort was followed-up for 24 months, to estimate healthcare utilizations and integrated costs for NHS. Prescription patterns, as drug choices and therapeutic changes, were described and analyzed in order to identify disease progression. A survival analysis was performed to estimate the occurrence time of the first relapse.

RESULTS: Out of a population of 5,174,723 adult women, 355 new cases of stage IV HR+/HER2- metastatic breast cancer were selected, with an incidence of 6.9 x 100,000. At the index date, these women generated an average cost of €3,888 for the hospitalization required to entry in the cohort. During the first follow-up year, they generated an average cost of €7,543; whereas, in the second year of €4,834. The main cost driver in the first year was outpatient services/visits, in the second year hospital admissions. Therapeutic switches occurred in 45.4% of the cohort, especially from chemotherapy to nonsteroidal aromatase inhibitors. A disease progression was identified in 22.5% of the cohort; the first relapse occurred within 13±6 months after the diagnosis.

CONCLUSIONS: The study provided a detailed picture of a specific group of breast cancer (i.e. stage IV HR+/HER2- metastatic breast cancer). These results should represent the starting point to evaluate the impact for NHS, in terms of both clinical benefits and economic burden, of new therapeutic strategies and procedures aimed to treat these patients.

Conference/Value in Health Info

2018-11, ISPOR Europe 2018, Barcelona, Spain

Value in Health, Vol. 21, S3 (October 2018)

Code

PCN260

Topic

Economic Evaluation

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies

Disease

Oncology

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