1
|
Rezaei S, Babaei M. A systematic literature review on direct and indirect costs of triple-negative breast cancer. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2023; 21:92. [PMID: 38037138 PMCID: PMC10688084 DOI: 10.1186/s12962-023-00503-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 11/24/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) is an aggressive and therapy-resistant form of breast cancer with a significant economic burden on patients and healthcare systems. Therefore, we completed a systematic review to classify and synthesize the literature on the direct and indirect costs of TNBC. METHODS Databases including ISI Web of Science, Scopus, PubMed, and Google Scholar were searched for all related articles assessing the economic burden of TNBC from 2010 until December 2022. The quality and eligibility assessments were done accordingly. We adjusted all costs to January 2023 $US. RESULTS From 881 records, 15 studies were eligible. We found that studies are widely disparate in the timetable, study design, patient populations, and cost components assessed. The annual per-patient direct costs of metastatic TNBC (mTNBC) were about $24,288 to $316,800. For early TNCB patients (eTNBC) this was about $21,120 to $105,600. Cancer management anticancer therapy costs account for the majority of direct costs. Along with an increase in cancer stage and line of therapy, healthcare costs were increased. Moreover, the indirect costs of patients with mTNBC and eTNBC were about $1060.875 and about $186,535 for each patient respectively. CONCLUSION The results showed that the direct and indirect costs of TNBC, mainly those of mTNBC, were substantial, suggesting attention to medical progress in cancer prognosis and therapy approaches.
Collapse
Affiliation(s)
- Sadeq Rezaei
- Faculty of Entrepreneurship, University of Tehran, Tehran, Iran
| | - Majid Babaei
- Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran.
| |
Collapse
|
2
|
Carreras MJ, Tomás-Guillén E, Farriols A, Renedo-Miró B, Valdivia C, Vidal J, Saura C, Carles J, Felip E, Gorgas MQ, Tabernero J, Monterde J. Use of Drugs in Clinical Practice and the Associated Cost of Cancer Treatment in Adult Patients with Solid Tumors: A 10-Year Retrospective Cohort Study. Curr Oncol 2023; 30:7984-8004. [PMID: 37754495 PMCID: PMC10528466 DOI: 10.3390/curroncol30090580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/10/2023] [Accepted: 08/26/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Cancer is one of the leading causes of morbidity and mortality in the world. Its growing incidence and prevalence, as well as the advances in diagnostic and treatment tools, motivate an open debate about the economic burden it may place on health systems and have raised concerns about access to this technological innovation. There is a lack of information on the detailed costs of pharmacological treatment of cancer in our health setting. In this context, it is necessary to know the use of drugs in cancer treatment in conditions of real clinical practice. A real-word, evidence-based retrospective cohort study was conducted at Vall d'Hebron University Hospital (VHUH), the largest hospital complex in Catalonia, Spain, in order to determine the use of drugs and the associated cost in real clinical practice for the treatment of solid tumors in adult patients attended at this institution over 10 years (2010-2019). METHODS This was a single-center retrospective cohort study of adult cancer patients attended in clinical practice at the Medical Oncology Department of VHUH between 1 January 2010 and 31 December 2019. Data of prescription, preparation, and cost of antineoplastic treatments were analyzed by pharmacological class (cytotoxic drugs, immunotherapy, targeted therapy, radiopharmaceuticals, and others), by antineoplastic agent, and by type of tumor. The number of patients and the pharmaceutical expenditure corresponding to all these subgroups were recorded. The cost per patient in each tumor location was also calculated. RESULTS The study population included 13,209 patients with an overall pharmaceutical antineoplastic expenditure of EUR 120,396,097, increasing from 7.67% in relation to the total HUVH pharmaceutical expenditure in 2010 to 12.82% in 2019. By pharmacological class, the specific weight of the cost of targeted therapy is relevant (75.22% of pharmaceutical antineoplastic expenditure, 21.3% of patients) compared to the group of conventional cytotoxics (17.25% of pharmaceutical antineoplastic expenditure, 76.37% of patients), while immunotherapy has represented the largest relative increase, from 5% in 2014 to 12% in 2019. Eight targeted therapy drugs represented 50% of the costs of the targeted therapy drug class (palbociclib, trastuzumab, pertuzumab, bevacizumab, nivolumab, cetuximab, pembrolizumab, and trastuzumab emtansine). Eleven tumor sites accounted for 90% of the expenditure in 71% of all patients. Breast cancer had the highest expenditure during the study period (EUR 34,332,210) and at each individual year. Melanoma showed the highest increase, with 9.7% of total pharmaceutical antineoplastic expenditure in 2019 (2% of patients), representing a paradigm of the rising costs of cancer treatment due to the incorporation of new high-cost therapies. The average annual cost per patient was highly variable depending on the pathology. There was a growing increase in costs per patient in most tumor locations, particularly in patients with melanoma (from EUR 1922 in 2010 to EUR 37,020 in 2019), prostate cancer (from EUR 2992 in 2010 to EUR 14,118 in 2019), and non-small cell lung cancer (from EUR 3545 in 2010 to EUR 8371 in 2019). The relevance of the difference in monthly cost per patient that has been identified for the different intrinsic subtypes in breast cancer patients during 2019 (HER2+ EUR 2661/month, Luminal EUR 881/month, Triple negative EUR 386/month) makes us consider suggesting differentiated reimbursement rates for certain clinical conditions. Finally, support treatment with antiemetic drugs, erythropoietin stimulating agents, granulocyte-colony stimulating factor (G-CSF), and bone resorption inhibitors has involved a cost of EUR 5,751,910, which represents 4.6% of the overall pharmacological cost of cancer treatment. CONCLUSION This study provides detailed insights on the oncological pharmaceutical expenditure for the treatment for solid tumors in the VHUH, based on real cost information from our hospital practice and for all antineoplastic therapies and types of solid tumors. This type of information on all the different types of cancer can be useful to better understand the economic burden of the disease and can be decisive for allocating public resources and funds for research, especially in those areas where information is scarce and therefore where further studies are needed. The contribution to knowledge of the cost of oncology therapy is of great value due to its realism and scope.
Collapse
Affiliation(s)
- Maria-Josep Carreras
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain; (A.F.); (B.R.-M.); (C.V.); (J.V.); (M.-Q.G.)
| | - Elena Tomás-Guillén
- Asserta Global Healthcare Solutions, Sant Quirze del Vallés, E-08192 Barcelona, Spain; (E.T.-G.); (J.M.)
| | - Anna Farriols
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain; (A.F.); (B.R.-M.); (C.V.); (J.V.); (M.-Q.G.)
| | - Berta Renedo-Miró
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain; (A.F.); (B.R.-M.); (C.V.); (J.V.); (M.-Q.G.)
| | - Carolina Valdivia
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain; (A.F.); (B.R.-M.); (C.V.); (J.V.); (M.-Q.G.)
| | - Jana Vidal
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain; (A.F.); (B.R.-M.); (C.V.); (J.V.); (M.-Q.G.)
| | - Cristina Saura
- Medical Oncology Department, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), E-08035 Barcelona, Spain; (C.S.); (J.C.); (E.F.); (J.T.)
| | - Joan Carles
- Medical Oncology Department, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), E-08035 Barcelona, Spain; (C.S.); (J.C.); (E.F.); (J.T.)
| | - Enriqueta Felip
- Medical Oncology Department, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), E-08035 Barcelona, Spain; (C.S.); (J.C.); (E.F.); (J.T.)
| | - Maria-Queralt Gorgas
- Pharmacy Department, Vall d’Hebron University Hospital, E-08035 Barcelona, Spain; (A.F.); (B.R.-M.); (C.V.); (J.V.); (M.-Q.G.)
| | - Josep Tabernero
- Medical Oncology Department, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), E-08035 Barcelona, Spain; (C.S.); (J.C.); (E.F.); (J.T.)
| | - Josep Monterde
- Asserta Global Healthcare Solutions, Sant Quirze del Vallés, E-08192 Barcelona, Spain; (E.T.-G.); (J.M.)
| |
Collapse
|
3
|
Buch-Villa E, Castañer-Puga C, Delgado-Garcia S, Fuster-Diana C, Vidal-Herrador B, Ripoll-Orts F, Galeote-Quecedo T, Prat A, Andrés-Matias M, Jimeno-Fraile J, Muñoz-Sorsona E, Vento G, Gumbau-Puchol V, Adrianzen M, López-Flor V, Ortega J. Clinical and cost outcomes of a polyethylene glycol (PEG)-coated patch versus drainage after axillary lymph node dissection in breast cancer: results from a multicentre randomized clinical trial. Br J Surg 2023; 110:1180-1188. [PMID: 37311694 PMCID: PMC10416686 DOI: 10.1093/bjs/znad150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/29/2023] [Accepted: 05/01/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND The aim of this study was to compare the clinical outcomes between breast cancer patients who underwent axillary lymph node dissection with postoperative management using a polyethylene glycol-coated patch versus axillary drainage. The direct costs associated with both postoperative management strategies were also evaluated. METHODS This was a multicentre RCT in women with breast cancer who underwent axillary lymph node dissection (ClinicalTrials.gov identifier: NCT04487561). Patients were randomly assigned (1 : 1) to receive either drainage or a polyethylene glycol-coated patch as postoperative management. The primary endpoints were the need for an emergency department visit for any event related to the surgery and the rate of seroma development. RESULTS A total of 227 patients were included , 115 in the patch group (50.7 per cent) and 112 (29.4 per cent ) in the drainage group. The incidence of emergency department visits was significantly greater for patients with drainage versus a polyethylene glycol-coated patch (incidence rate difference 26.1 per cent, 95 per cent c.i. 14.5 to 37.7 per cent; P < 0.001). Conversely, the seroma rate was significantly higher in the polyethylene glycol-coated patch group (incidence rate difference 22.8 per cent, 95 per cent c.i. 6.7 to 38.9 per cent; P < 0.0055). Compared with drainage, using a polyethylene glycol-coated patch resulted in cost savings of €100.41 per patient. An incremental cost-effectiveness ratio analysis found that drainage was associated with an incremental cost-effectiveness ratio of €7594.4 for no need for hospital admission and €491.7 for no need for an emergency department visit. CONCLUSION Compared with patients who received drainage after axillary lymph node dissection, the use of a polyethylene glycol-coated patch resulted in a higher rate of seroma, but a lower number of postoperative outpatient or emergency department visits and thus a reduction in overall costs.
Collapse
Affiliation(s)
- Elvira Buch-Villa
- Department of Surgery, University Clinical Hospital of Valencia, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | | | | | - Carlos Fuster-Diana
- Department of Surgery, Valencian Institute of Oncology (IVO), Valencia, Spain
| | - Beatriz Vidal-Herrador
- Department of Surgery, University Clinical Hospital of Santiago de Compostela, A Coruña, Spain
| | | | | | - Antonio Prat
- Department of Surgery, General Hospital of Requena, Valencia, Spain
| | | | - Jaime Jimeno-Fraile
- Department of Surgery, University Clinical Hospital of Marques de Valdecilla, Santander, Spain
| | - Ernesto Muñoz-Sorsona
- Department of Surgery, University Clinical Hospital of Valencia, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Giovani Vento
- Department of Surgery, Valencian Institute of Oncology (IVO), Valencia, Spain
| | | | - Marcos Adrianzen
- Department of Surgery, University Clinical Hospital of Valencia, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Vicente López-Flor
- Department of Surgery, University Clinical Hospital of Valencia, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Joaquín Ortega
- Department of Surgery, University Clinical Hospital of Valencia, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
| |
Collapse
|
4
|
Mohammadpour S, Soleimanpour S, Javan-Noughabi J, Gallehzan NA, Aboutorabi A, Jahangiri R, Bagherzadeh R, Gorman JF, Nemati A. A systemmatic literature review on indirect costs of women with breast cancer. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2022; 20:68. [PMID: 36510211 PMCID: PMC9742666 DOI: 10.1186/s12962-022-00408-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION The rising incidence of breast cancer places a financial burden on national health services and economies. The objective of this review is to present a detailed analysis of the research and literature on indirect costs of breast cancer. METHODS English literature databases from 2000 to 2020 were searched to find studies related to the objective of the present review. Study selection and data extraction was undertaken independently by two authors. Also, quality assessment was done using a checklist designed by Stunhldreher et al. RESULTS: The current study chose 33 studies that were eligible from a total of 2825 records obtained. The cost of lost productivity due to premature death based on human capital approach ranged from $22,386 to $52 billion. The cost burden from productivity lost due to premature death based on friction cost approach ranged from $1488.61 to $4,518,628.5. The cost burden from productivity lost due to morbidity with the human capital approach was reported as $126,857,360.69 to $596,659,071.28. The cost of lost productivity arising from informal caregivers with the human capital approach was $297,548.46 to $308 billion. CONCLUSION Evaluation of the existing evidence revealed the indirect costs of breast cancer in women to be significantly high. This study did a thorough review on the indirect costs associated with breast cancer in women which could serve as a guide to help pick the appropriate method for calculating the indirect costs of breast cancer based on existing methods, approach and data. There is a need for calculations to be standardised since the heterogeneity of results in different domains from various studies makes it impossible for comparisons to be made among different countries.
Collapse
Affiliation(s)
- Saeed Mohammadpour
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Samira Soleimanpour
- Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Javad Javan-Noughabi
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Nasrin Aboulhasanbeigi Gallehzan
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Aboutorabi
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Jahangiri
- Department of Health Economics, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Rafat Bagherzadeh
- English Language Department, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Julia F Gorman
- Graduate School of Humanities and Social Sciences, University of Melbourne, Melbourne, Australia
| | - Ali Nemati
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Merollini KMD, Gordon LG, Ho YM, Aitken JF, Kimlin MG. Cancer Survivors’ Long-Term Health Service Costs in Queensland, Australia: Results of a Population-Level Data Linkage Study (Cos-Q). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159473. [PMID: 35954835 PMCID: PMC9368477 DOI: 10.3390/ijerph19159473] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 12/04/2022]
Abstract
Worldwide, the number of cancer survivors is rapidly increasing. The aim of this study was to quantify long-term health service costs of cancer survivorship on a population level. The study cohort comprised residents of Queensland, Australia, diagnosed with a first primary malignancy between 1997 and 2015. Administrative databases were linked with cancer registry records to capture all health service utilization. Health service costs between 2013–2016 were analyzed using a bottom-up costing approach. The cumulative mean annual healthcare expenditure (2013–2016) for the cohort of N = 230,380 individuals was AU$3.66 billion. The highest costs were incurred by patients with a history of prostate (AU$538 m), breast (AU$496 m) or colorectal (AU$476 m) cancers. Costs by time since diagnosis were typically highest in the first year after diagnosis and decreased over time. Overall mean annual healthcare costs per person (2013–2016) were AU$15,889 (SD: AU$25,065) and highest costs per individual were for myeloma (AU$45,951), brain (AU$30,264) or liver cancer (AU$29,619) patients. Our results inform policy makers in Australia of the long-term health service costs of cancer survivors, provide data for economic evaluations and reinforce the benefits of investing in cancer prevention.
Collapse
Affiliation(s)
- Katharina M. D. Merollini
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD 4558, Australia
- Sunshine Coast Health Institute, Birtinya, QLD 4575, Australia
- Correspondence: ; Tel.: +61-7-5202-3159
| | - Louisa G. Gordon
- Health Economics, Population Health Department, QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia;
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia;
- School of Biomedical Sciences, Queensland University of Technology, St. Lucia, QLD 4072, Australia;
| | - Yiu M. Ho
- Rockhampton Hospital, Central Queensland Hospital and Health Service, Rockhampton, QLD 4700, Australia;
- Rural Clinical School, The University of Queensland, Rockhampton, QLD 4700, Australia
| | - Joanne F. Aitken
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia;
- Cancer Council Queensland, Fortitude Valley, QLD 4006, Australia
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4006, Australia
| | - Michael G. Kimlin
- School of Biomedical Sciences, Queensland University of Technology, St. Lucia, QLD 4072, Australia;
| |
Collapse
|
6
|
Spanggaard M, Olsen J, Jensen KF, Anderson M. Cost of illness of HER2-positive and metastatic and recurrent HER2-positive breast cancer – a Danish register-based study from 2005 to 2016. BMC Health Serv Res 2022; 22:745. [PMID: 35659675 PMCID: PMC9167500 DOI: 10.1186/s12913-022-08143-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 05/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background Information and knowledge about cost of illness and labour productivity in patients with HER2-positive early-stage and metastatic breast cancer treated with trastuzumab is limited. The aim of this study was to estimate the direct and indirect costs associated with treatment of HER2-positive breast cancer among patients with early-stage and metastatic breast cancer, treated with trastuzumab, in a 10-year period after diagnosis. Materials and methods This study included all Danish HER2-positive breast cancer patients (≥ 18 years) treated with trastuzumab between 2005 and 2016 identified in The Danish Patient Register and the Danish Cancer Register. Furthermore, we identified patients experiencing metastatic or recurrent breast cancer. For the study populations, we estimated total direct costs and indirect costs for one year prior to the breast cancer diagnosis and up to 10 years after diagnosis compared with a group of matched controls free of breast cancer. In addition to The Danish Patient Register and Cancer Register, we applied patient level data from The Civil Registration System, The National Pathology Register, National Health Service Register for Primary Care, Register of Medicinal Product Statistics, Register of Municipal Services, The DREAM database, and Population’s Education Register. Results We identified 4,153 HER2-positive breast cancer patients, whereof 27% were identified with metastatic or recurrent breast cancer. During the follow-up period of 10 years, we estimated excess direct costs of EUR 115,000 among the total study population compared to controls; EUR 211,000 among patients with metastases or recurrence; and EUR 89,000 among patients without metastases or recurrence. Direct costs were found to be highest in the first year after diagnosis and also peaked in the year after recurrence. Labour productivity was significantly lower among patients with recurrence 10 years after breast cancer diagnosis compared with controls. Conclusions In this study, we estimated the direct and indirect cost associated with HER2-positive breast cancer. The costs were significantly higher during the 10 years after diagnosis compared to the control group, specifically among patients experiencing metastases or recurrence of breast cancer. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08143-7.
Collapse
|
7
|
Huang M, Haiderali A, Fox GE, Frederickson A, Cortes J, Fasching PA, O'Shaughnessy J. Economic and Humanistic Burden of Triple-Negative Breast Cancer: A Systematic Literature Review. PHARMACOECONOMICS 2022; 40:519-558. [PMID: 35112331 PMCID: PMC9095534 DOI: 10.1007/s40273-021-01121-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/28/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) accounts for 10-20% of all breast cancers (BCs). It is more commonly diagnosed in younger women and often has a less favorable prognosis compared with other BC subtypes. OBJECTIVE The objective of this study was to provide a literature-based extensive overview of the economic and humanistic burden of TNBC to assist medical decisions for healthcare payers, providers, and patients. METHODS A systematic literature review was performed using multiple databases, including EMBASE, MEDLINE, Econlit, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews, from database inception to 16 May 2021. In addition, a targeted search was performed in the Northern Light Life Sciences Conference Abstracts database from 2016 through June 2021. The bibliographies of included articles were reviewed to identify other potentially relevant publications. Quality assessment of the included studies was conducted. RESULTS The review identified 19 studies assessing the economic burden and 10 studies assessing the humanistic burden of TNBC. Studies varied widely in study design, settings, patient populations, and time horizons. The estimates of mean per-patient annual direct medical costs ranged from around $20,000 to over $100,000 in stage I-III TNBC and from $100,000 to $300,000 in stage IV TNBC. Healthcare costs and resource utilization increased significantly with disease recurrence, progression, and increased cancer stage or line of therapy. Compared with the costs of systemic anticancer therapy, cancer management costs comprised a larger portion of total direct costs. The estimates of indirect costs due to productivity loss ranged from $207 to $1573 per patient per month (all costs presented above were adjusted to 2021 US dollars). Cancer recurrence led to significantly reduced productivity and greater rates of leaving the workforce. A rapid deterioration of health utility associated with disease progression was observed in TNBC patients. Treatment with pembrolizumab or talazoparib showed significantly greater improvements in health-related quality of life (HRQoL) compared with chemotherapy, as measured by EORTC QLQ-C30, QLQ-BR23, and FACT-B. CONCLUSION TNBC is associated with a substantial economic burden on healthcare systems and societies and considerably reduced productivity and HRQoL for patients. This study synthesized the published literature on the economic and humanistic burden of TNBC and highlighted the need for continued research due to the rapidly changing landscape of TNBC care.
Collapse
Affiliation(s)
- Min Huang
- Merck & Co., Inc., Kenilworth, NJ, USA.
| | | | | | | | - Javier Cortes
- International Breast Cancer Center (IBCC), Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen, EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen, Nuremberg, Erlangen, Germany
| | - Joyce O'Shaughnessy
- Baylor University Medical Center, Texas Oncology and US Oncology, Dallas, TX, USA
| |
Collapse
|
8
|
Silva DAS. Hospitalization and ambulatory costs related to breast cancer due to physical inactivity in the Brazilian state capitals. PLoS One 2022; 17:e0261019. [PMID: 35045087 PMCID: PMC8769291 DOI: 10.1371/journal.pone.0261019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 11/22/2021] [Indexed: 01/04/2023] Open
Abstract
The aim of this study was to estimate the hospitalization and ambulatory costs related to breast cancer due to physical inactivity in the female population from Brazilian capitals over a three-year period (2015 to 2017). This study was carried out with data from the Brazilian health system and had as metrics incidence of breast cancer, total and standardized rate hospitalizations by breast cancer, hospitalization and ambulatory costs by breast cancer and prevalence of physical inactivity. The Population Attributable Fraction (PAF) calculation was used. The total hospitalization cost by breast cancer in women aged ≥ 20 years in Brazil from 2015 to 2017 was US$ 33,484,920.54. Of this total, US$ 182,736.76 was due to physical inactivity. Outpatient expenses related to breast cancer in the Brazilian female population from 2015 to 2017 was US$ 207,993,744.39. Of this total, US$ 1,178,841.86 was due to physical inactivity. Outpatient and hospitalization expenses were higher in the states of Southeastern, Southern and Northeastern regions. Physical inactivity has contributed to the high number of hospitalizations for breast cancer in Brazil, which resulted in economic burden for health services (inpatient and outpatient) of more than US$ 1,300,000.00 from 2015 to 2017.
Collapse
Affiliation(s)
- Diego Augusto Santos Silva
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianopolis, Brazil
| |
Collapse
|
9
|
Chen HM, Chen JH, Chiang SC, Lin YC, Ko Y. An evaluation of the healthcare costs of metastatic breast cancer: A retrospective matched cohort study. Medicine (Baltimore) 2021; 100:e27567. [PMID: 34713830 PMCID: PMC8556009 DOI: 10.1097/md.0000000000027567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/04/2021] [Indexed: 01/05/2023] Open
Abstract
To determine the economic burden of metastatic breast cancer (MBC) in Taiwan, we conducted a national retrospective claim database analysis to evaluate the incremental healthcare costs and utilization of MBC patients as compared to their breast cancer (BC) and breast cancer free (BCF) counterparts.Data were obtained from the National Health Insurance Claim Database and the Taiwan Cancer Registry database between 2012 and 2015. All healthcare utilization and costs were calculated on a per-patient-per-month (PPPM) basis and were compared among groups using the generalized linear model adjusting for age group, residential area, and Charlson comorbidity index group.A total of 1,606 MBC patients were matched to 6,424 BC patients and 6,424 BCF patients. The majority of overall MBC healthcare costs were attributed to outpatient costs (75.1%), followed by inpatient (23.2%) and emergency room costs (1.7%). The PPPM total healthcare costs of the MBC, BC, and BCF groups were TWD 7,422, 14,425, and 2,114, respectively. The adjusted PPPM total healthcare cost ratio of MBC to BCF was 4.1. Compared to BCF patients, the patients receiving both human epidermal growth factor receptor 2-targeted therapy and endocrine therapy incurred 28.1 times PPPM total costs. The adjusted PPPM total healthcare cost ratio of recurrent MBC to BCF was 2.3, while the ratio was 12.2 in the de novo MBC group.Patients with MBC are associated with substantial economic burden, particularly in outpatient costs. The study findings could be useful for MBC-related economic evaluations and health resource allocation.
Collapse
Affiliation(s)
- Hsuan-Ming Chen
- Department of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Jin-Hua Chen
- Statistics Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Shao-Chin Chiang
- Department of Pharmacy, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Yi-Chun Lin
- Statistics Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan
| | - Yu Ko
- Department of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Research Center of Pharmacoeconomics, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
10
|
Rodrigues-Oliveira L, Kowalski LP, Santos M, Marta GN, Bensadoun RJ, Martins MD, Lopes MA, Castro GD, William WN, Chaves ALF, Migliorati CA, Salloum RG, Rodrigues-Fernandes CI, Kauark-Fontes E, Brandão TB, Santos-Silva AR, Prado-Ribeiro AC. Direct costs associated with the management of mucositis: A systematic review. Oral Oncol 2021; 118:105296. [PMID: 33933777 DOI: 10.1016/j.oraloncology.2021.105296] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/26/2021] [Accepted: 04/04/2021] [Indexed: 11/26/2022]
Abstract
Mucositis is one of the more frequent and costly adverse events following cancer treatment. To evaluate and report the direct economic outcomes associated with the management of mucositis across several cancer treatments we conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Scopus, MEDLINE/PubMed, and Embase were searched electronically and a total of 37 relevant studies were included. The costs attributable to mucositis in the hematopoietic stem cell transplantation setting ranged from 1124,47 US dollars (USD) to 299 214,14 USD per patient. The radiotherapy/chemoradiotherapy/radiotherapy plus molecular targeted therapy accounted for mucositis costs that ranged from 51,23 USD to 33 560,58 USD per patient. Costs for mucositis in the chemotherapy setting ranged from 4,18 USD to 31 963,64 USD per patient. When the cancer treatment was not specified, costs of mucositis ranged from 565,85 USD to as high as 20 279, 12 USD per patient. Mucositis costs from multimodal therapy ranged from 12,42 USD to 5670,46 USD per patient. The molecular targeted therapy setting included only one study and depending on the healthcare providers' perspective of each country evaluated, mucositis' costs ranged from 45,78 USD to 3484,91 USD per patient. Mucositis is associated with increased resource use, consultations, hospitalizations and extended hospitalizations, leading to a substantial incremental cost that exacerbates the economic burden on the patient, health plan and health system across several cancer treatments and diagnosis. More studies with a prospective evaluation of the economic costs associated with mucositis management are needed.
Collapse
Affiliation(s)
- Leticia Rodrigues-Oliveira
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areião, 13414-903 Piracicaba, São Paulo, Brazil
| | - Luiz Paulo Kowalski
- Head and Neck Surgery Department, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455, Cerqueira César, 01246-903 São Paulo, São Paulo, Brazil; Department of Head and Neck Surgery and Otorhinolaryngology, A C Camargo Cancer Center, Rua Tamandaré, 753, Liberdade, 01525-001 São Paulo, São Paulo, Brazil; Latin American Cooperative Oncology Group, Brazilian Group of Head and Neck Cancer, Brazil.
| | - Marcos Santos
- ISPOR - International Society for Pharmacoeconomics and Outcomes Research, Brazil; Latin American Cooperative Oncology Group, Brazilian Group of Head and Neck Cancer, Brazil
| | - Gustavo Nader Marta
- Division of Radiation Oncology, São Paulo State Cancer Institute (ICESP-FMUSP), Av. Dr. Arnaldo, 251, Cerqueira César, 01246-000 São Paulo, São Paulo, Brazil; Department of Radiation Oncology, Hospital Sírio-Libanês, Rua Dona Adma Jafet, 115, Bela Vista, 01308-050 São Paulo, São Paulo, Brazil; Latin American Cooperative Oncology Group, Brazilian Group of Head and Neck Cancer, Brazil.
| | - René-Jean Bensadoun
- Centre de Haute Energie (CHE), 10, Boulevard Pasteur, 06000 Nice, Nice, France.
| | - Manoela Domingues Martins
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areião, 13414-903 Piracicaba, São Paulo, Brazil; Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Santa Cecilia, 90035-003 Porto Alegre, Rio Grande do Sul, Brazil
| | - Marcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areião, 13414-903 Piracicaba, São Paulo, Brazil
| | - Gilberto de Castro
- Department of Medical Oncology, São Paulo State Cancer Institute (ICESP-FMUSP), Av. Dr. Arnaldo, 251, Cerqueira César, 01246-000 São Paulo, São Paulo, Brazil; Latin American Cooperative Oncology Group, Brazilian Group of Head and Neck Cancer, Brazil.
| | - William Nassib William
- Centro Oncológico BP, Beneficência Portuguesa de São Paulo, Rua Maestro Cardim, 769, Bela Vista, 01323-001 São Paulo, São Paulo, Brazil; Latin American Cooperative Oncology Group, Brazilian Group of Head and Neck Cancer, Brazil
| | - Aline Lauda Freitas Chaves
- DOM Oncology Group, Av. Antônio Olímpio de Morais, 1990, Santa Clara, 35500-071 Divinópolis, Minas Gerais, Brazil; Latin American Cooperative Oncology Group, Brazilian Group of Head and Neck Cancer, Brazil
| | | | - Ramzi G Salloum
- College of Medicine, University of Florida, 600 SW Archer Rd, Gainesville, FL 32610, USA.
| | - Carla Isabelly Rodrigues-Fernandes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areião, 13414-903 Piracicaba, São Paulo, Brazil
| | - Elisa Kauark-Fontes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areião, 13414-903 Piracicaba, São Paulo, Brazil
| | - Thaís Bianca Brandão
- Dental Oncology Service, São Paulo State Cancer Institute (ICESP-FMUSP), Av. Dr. Arnaldo, 251, Cerqueira César, 01246-000 São Paulo, São Paulo, Brazil.
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areião, 13414-903 Piracicaba, São Paulo, Brazil; Latin American Cooperative Oncology Group, Brazilian Group of Head and Neck Cancer, Brazil.
| | - Ana Carolina Prado-Ribeiro
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areião, 13414-903 Piracicaba, São Paulo, Brazil; Dental Oncology Service, São Paulo State Cancer Institute (ICESP-FMUSP), Av. Dr. Arnaldo, 251, Cerqueira César, 01246-000 São Paulo, São Paulo, Brazil.
| |
Collapse
|
11
|
Merollini KMD, Gordon LG, Aitken JF, Kimlin MG. Lifetime Costs of Surviving Cancer-A Queensland Study (COS-Q): Protocol of a Large Healthcare Data Linkage Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082831. [PMID: 32326074 PMCID: PMC7216287 DOI: 10.3390/ijerph17082831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/17/2020] [Accepted: 04/18/2020] [Indexed: 12/15/2022]
Abstract
Australia-wide, there are currently more than one million cancer survivors. There are over 32 million world-wide. A trend of increasing cancer incidence, medical innovations and extended survival places growing pressure on healthcare systems to manage the ongoing and late effects of cancer treatment. There are no published studies of the long-term health service use and cost of cancer survivorship on a population basis in Australia. All residents of the state of Queensland, Australia, diagnosed with a first primary malignancy from 1997–2015 formed the cohort of interest. State and national healthcare databases are linked with cancer registry records to capture all health service utilization and healthcare costs for 20 years (or death, if this occurs first), starting from the date of cancer diagnosis, including hospital admissions, emergency presentations, healthcare costing data, Medicare services and pharmaceuticals. Data analyses include regression and economic modeling. We capture the whole journey of health service contact and estimate long-term costs of all cancer patients diagnosed and treated in Queensland by linking routinely collected state and national healthcare data. Our results may improve the understanding of lifetime health effects faced by cancer survivors and estimate related healthcare costs. Research outcomes may inform policy and facilitate future planning for the allocation of healthcare resources according to the burden of disease.
Collapse
Affiliation(s)
- Katharina M. D. Merollini
- Sunshine Coast Health Institute, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, QLD 4558, Australia;
- Correspondence: ; Tel.: +61 7 5202 3159
| | - Louisa G. Gordon
- QIMR Berghofer, Medical Research Institute, Herston, QLD 4006, Australia;
- School of Nursing, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Joanne F. Aitken
- Cancer Council Queensland, Fortitude Valley, QLD 4006, Australia;
- Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD 4305, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia
| | - Michael G. Kimlin
- Sunshine Coast Health Institute, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, QLD 4558, Australia;
- School of Biomedical Sciences, Queensland University of Technology, St Lucia, QLD 4072, Australia
| |
Collapse
|
12
|
Mancha RG, Muñoz M, de la Cruz-Merino L, Calvo L, Cruz J, Baena-Cañada JM, Fernandez Y, Ramos M, Rodriguez CA, Chacón JI, Palomero I, Llinares J, Rivero M, Ruiz MÁ. Development and validation of a sexual relations satisfaction scale in patients with breast cancer - "SEXSAT-Q". Health Qual Life Outcomes 2019; 17:143. [PMID: 31420041 PMCID: PMC6698031 DOI: 10.1186/s12955-019-1197-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 07/17/2019] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Because the currently available questionnaires to evaluate sexual changes on breast cancer women only address the sexual sphere with a few questions our purpose was to develop a questionnaire that assesses changes in sexual dysfunction and satisfaction in women treated for breast cancer. METHODS A sample was selected of women aged between 18 and 65 who had had surgery for breast cancer, completed neoadjuvant/adjuvant chemotherapy treatment and could be receiving adjuvant hormonal treatment, with an active sex life at least 3 months before starting treatment. Metastatic disease was excluded. A questionnaire structured in 4 dimensions was developed. The MOS SF-12 and QLQ-BR23 questionnaires were also provided. The following metric properties were evaluated: item analysis; internal consistency; temporal stability; construct validity; concurrent, convergent and divergent validity; and feasibility. RESULTS Three samples were recruited: a pilot sample of 20; a reduction sample of 152; and a validation sample of 148. The presence of 6 dimensions was confirmed: 1) Loss of sex drive; 2) worsening of body image; 3) psychological coping; 4) discomfort during intercourse; 5) satisfaction with sexual relations; and 6) satisfaction with breast reconstruction. Good goodness-of-fit statistics were obtained (χ2/df = 1.5, GFI = 0.9, AGFI = 0.84, CFI = 0.959, RMSEA = 0.062). Reliability was good (α = 0.855), as was test-retest stability (r = 0.838). The correlation with the convergent questionnaires proved to be higher than that obtained with generic measurements. CONCLUSIONS We were able to develop a short questionnaire (17 items) capable of measuring sexual satisfaction in women with breast cancer with good metric properties.
Collapse
Affiliation(s)
| | - Montserrat Muñoz
- Medical Oncology Department, Hospital Universitario Clínic —, Barcelona, Spain
| | - Luis de la Cruz-Merino
- Medical Oncology Department, Hospital Universitario Virgen de la Macarena, Seville, Spain
| | - Lourdes Calvo
- Medical Oncology Department, Complejo Hospitalario Universitarios A Coruña (CHUAC), A Coruña, Spain
| | - Josefina Cruz
- Medical Oncology Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | | | - Yolanda Fernandez
- Medical Oncology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Manuel Ramos
- Medical Oncology Department, Centro Oncológico de Galicia, A Coruña, Spain
| | - Cesar Augusto Rodriguez
- Medical Oncology Department, Hospital Clínico Universitario de Salamanca — IBSAL, Salamanca, Spain
| | - Jose Ignacio Chacón
- Medical Oncology Department, Hospital Universitario Virgen de la Salud, Toledo, Spain
| | - Isabel Palomero
- Medical Oncology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Julia Llinares
- Laboratorios Pfizer España, Avenida de Europa, 20 – B- Parque Empresarial La Moraleja, 28108 Alcobendas (Madrid), Spain
| | - María Rivero
- Laboratorios Pfizer España, Avenida de Europa, 20 – B- Parque Empresarial La Moraleja, 28108 Alcobendas (Madrid), Spain
| | - Miguel Ángel Ruiz
- Psychology Department, Universidad Autónoma de Madrid, Madrid, Spain
| |
Collapse
|