Patterns of resource utilization and cost for postmenopausal women with hormone-receptor–positive, human epidermal growth factor receptor-2–negative advanced breast cancer in Europe

BMC Cancer

Research Article

Guy Jerusalem¹  Fabrice Andre²  Nina Marinsek³  Ravi Degun³  Giancarlo Benelli⁴  Jie Zhang⁵  Stephen Saletan⁵  Patrick Neven⁶  Jean-François Ricci⁷ 

[1] Centre Hospitalier Universitaire Sart Tilman Liège and Liège University, Domaine Universitaire du Sart Tilman, B35, 4000, Liège, Belgium;Institut Gustave Roussy, 39 Rue C. Desmoulins, 94805, Villejuif, France;Navigant Consulting, Inc, Woolgate Exchange, 25 Basinghall Street, EC2V 5HA, London, UK;Novartis Farma S.p.A., Largo Umberto Boccioni 1, I-21040, Origgio, VA, Italy;Novartis Pharmaceuticals Corporation, One Health Plaza, 07936-1080, East Hanover, NJ, USA;University Hospitals Leuven, box 7003, Herestraat 49, B-3000, Leuven, Belgium;Wellmera AG, Basel, Switzerland;

关键词: Advanced breast cancer;    Direct costs;    Europe;    Resource utilization;    Work productivity;   

DOI  :  10.1186/s12885-015-1762-3

 received in 2014-12-31, accepted in 2015-10-09,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundHealthcare resource utilization in breast cancer varies by disease characteristics and treatment choices. However, lack of clarity in guidelines can result in varied interpretation and heterogeneous treatment management and costs. In Europe, the extent of this variability is unclear. Therefore, evaluation of chemotherapy use and costs versus hormone therapy across Europe is needed.MethodsThis retrospective chart review (N = 355) examined primarily direct costs for chemotherapy versus hormone therapy in postmenopausal women with hormone-receptor–positive (HR+), human epidermal growth factor receptor-2–negative (HER2–) advanced breast cancer across 5 European countries (France, Germany, The Netherlands, Belgium, and Sweden).ResultsTotal direct costs across the first 3 treatment lines were approximately €10 000 to €14 000 lower for an additional line of hormone therapy-based treatment versus switching to chemotherapy-based treatment. Direct cost difference between chemotherapy-based and hormone therapy-based regimens was approximately €1900 to €2500 per month. Chemotherapy-based regimens were associated with increased resource utilization (managing side effects; concomitant targeted therapy use; and increased frequencies of hospitalizations, provider visits, and monitoring tests). The proportion of patients taking sick leave doubled after switching from hormone therapy to chemotherapy.ConclusionsThese results suggest chemotherapy is associated with increased direct costs and potentially with increased indirect costs (lower productivity of working patients) versus hormone therapy in HR+, HER2– advanced breast cancer.

【 授权许可】

CC BY   
© Jerusalem et al. 2015