Christine Brezden-Masley1, Kelly E Fathers2, Megan E Coombes3, Behin Pourmirza2, Cloris Xue2, Katarzyna J Jerzak4. 1. Division of Medical Oncology and Hematology, Faculty of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada. 2. Department of Medical Affairs, Hoffmann-La Roche Limited, Mississauga, ON, Canada. 3. Market Access and Pricing Department, Hoffmann-La Roche Limited, Mississauga, ON, Canada. 4. Division of Medical Oncology and Hematology, Faculty of Medicine, Sunnybrook Odette Cancer Center, University of Toronto, Toronto, ON, Canada. katarzyna.jerzak@sunnybrook.ca.
Abstract
PURPOSE: We sought to expand the currently limited, Canadian, population-based data on the characteristics, treatment pathways, and health care costs according to stage in patients with human epidermal growth factor receptor-2 positive (HER2+) breast cancer (BC). METHODS: We extracted data from the publicly funded health care system in Ontario. Baseline characteristics, treatment patterns, and health care costs were descriptively compared by cancer stage (I-III vs. IV) for adult women diagnosed with invasive HER2+ BC between 2012 and 2016. Resource use was multiplied by unit costs for publicly funded health care services to calculate costs. RESULTS: Overall, 4535 patients with stage I-III and 354 with stage IV HER2+ BC were identified. Most patients with stage I-III disease were treated with surgery (4372, 96.4%), with the majority having a lumpectomy, and 3521 (77.6%) received radiation. Neoadjuvant (NAT) and adjuvant (AT) systemic treatment rates were 20.1% (n = 920) and 88.8% (n = 3065), respectively. Systemic treatment was received by 311 patients (87.9%) with metastatic HER2+ BC, 264 of whom (84.9%) received trastuzumab. Annual health care costs per patient were nearly 3 times higher for stage IV vs. stage I-III HER2+ BC. CONCLUSION: Per-patient annual costs were substantially higher for women with metastatic HER2+ BC, despite less frequent exposure to surgery and radiation compared to those with early stage disease. Increasing NAT rates in early stage disease represent a critical opportunity to prevent recurrence and reduce the costs associated with treating metastatic HER2+ BC.
PURPOSE: We sought to expand the currently limited, Canadian, population-based data on the characteristics, treatment pathways, and health care costs according to stage in patients with humanepidermal growth factor receptor-2 positive (HER2+) breast cancer (BC). METHODS: We extracted data from the publicly funded health care system in Ontario. Baseline characteristics, treatment patterns, and health care costs were descriptively compared by cancer stage (I-III vs. IV) for adult women diagnosed with invasive HER2+ BC between 2012 and 2016. Resource use was multiplied by unit costs for publicly funded health care services to calculate costs. RESULTS: Overall, 4535 patients with stage I-III and 354 with stage IV HER2+ BC were identified. Most patients with stage I-III disease were treated with surgery (4372, 96.4%), with the majority having a lumpectomy, and 3521 (77.6%) received radiation. Neoadjuvant (NAT) and adjuvant (AT) systemic treatment rates were 20.1% (n = 920) and 88.8% (n = 3065), respectively. Systemic treatment was received by 311 patients (87.9%) with metastatic HER2+ BC, 264 of whom (84.9%) received trastuzumab. Annual health care costs per patient were nearly 3 times higher for stage IV vs. stage I-III HER2+ BC. CONCLUSION: Per-patient annual costs were substantially higher for women with metastatic HER2+ BC, despite less frequent exposure to surgery and radiation compared to those with early stage disease. Increasing NAT rates in early stage disease represent a critical opportunity to prevent recurrence and reduce the costs associated with treating metastatic HER2+ BC.
Entities:
Keywords:
Breast neoplasms; Drug therapy; Epidemiologic studies; Health expenditures; Health services research; Receptor ErbB-2
Authors: Laura Cortesi; Angela Toss; Claudia Cirilli; Luigi Marcheselli; Barbara Braghiroli; Federica Sebastiani; Massimo Federico Journal: Int J Cancer Date: 2015-03-23 Impact factor: 7.396
Authors: Antonio C Wolff; M Elizabeth H Hammond; Jared N Schwartz; Karen L Hagerty; D Craig Allred; Richard J Cote; Mitchell Dowsett; Patrick L Fitzgibbons; Wedad M Hanna; Amy Langer; Lisa M McShane; Soonmyung Paik; Mark D Pegram; Edith A Perez; Michael F Press; Anthony Rhodes; Catharine Sturgeon; Sheila E Taube; Raymond Tubbs; Gail H Vance; Marc van de Vijver; Thomas M Wheeler; Daniel F Hayes Journal: J Clin Oncol Date: 2006-12-11 Impact factor: 44.544
Authors: Nicole Mittmann; Ning Liu; Stephanie Y Cheng; Soo Jin Seung; Farah E Saxena; Nicole J Look Hong; Craig C Earle; Matthew C Cheung; Natasha B Leighl; Natalie G Coburn; Carlo DeAngelis; William K Evans Journal: CMAJ Open Date: 2020-03-16
Authors: Gunter von Minckwitz; Chiun-Sheng Huang; Max S Mano; Sibylle Loibl; Eleftherios P Mamounas; Michael Untch; Norman Wolmark; Priya Rastogi; Andreas Schneeweiss; Andres Redondo; Hans H Fischer; William Jacot; Alison K Conlin; Claudia Arce-Salinas; Irene L Wapnir; Christian Jackisch; Michael P DiGiovanna; Peter A Fasching; John P Crown; Pia Wülfing; Zhimin Shao; Elena Rota Caremoli; Haiyan Wu; Lisa H Lam; David Tesarowski; Melanie Smitt; Hannah Douthwaite; Stina M Singel; Charles E Geyer Journal: N Engl J Med Date: 2018-12-05 Impact factor: 176.079
Authors: Danielle R Heller; Alexander S Chiu; Kaitlin Farrell; Brigid K Killelea; Donald R Lannin Journal: Cancers (Basel) Date: 2019-04-08 Impact factor: 6.639