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Original article
The economic burden of metastatic breast cancer in Spain
  1. Begoña Bermejo de las Heras1,
  2. Javier Cortes Ramon y Cajal2,
  3. Elena Galve Calvo3,
  4. Juan de la Haba Rodriguez4,5,
  5. Jesus Garcia Mata6,
  6. Fernando Moreno Anton7,
  7. Ignacio Pelaez Fernandez8,
  8. Alvaro Rodriguez-Lescure9,10,
  9. Cesar A Rodriguez Sanchez11,
  10. Manuel Ruiz-Borrego12,
  11. Edit Remak13,
  12. Magdolna Barra13,
  13. Maria Rivero14,
  14. Javier Soto Alvarez14
  1. 1Hospital Clinico Universitario de Valencia, Valencia, Spain
  2. 2Madrid & Vall d’Hebron Institute of Oncology (VHIO), University Hospital, Barcelona, Spain
  3. 3Basurto Hospital, Bilbao, Spain
  4. 4Medical Oncology Department, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
  5. 5Spanish Cancer Network (RTICC), Instituto de Salud Carlos III, Madrid, Spain
  6. 6Xerencia de Xestión Integrada de Ourense, Complexo Hospitalario Universitario de Ourense, Verín e o Barco de Valdeorras, Spain
  7. 7Oncology Department, Hospital Clíinico San Carlos, Madrid, Spain
  8. 8Hospital Universitario de Cabueñes at Gijón, Gijon, Spain
  9. 9Hospital General Universitario de Elche, Alicante, Spain
  10. 10Spain and Spanish Breast Cancer Research Group (GEICAM), Madrid, Spain
  11. 11Hospital Universitario de Salamanca – IBSAL, Salamanca, Spain
  12. 12Hospital Universitario Virgen del Rocío, Seville, Spain
  13. 13Evidera, Budapest, Hungary
  14. 14Pfizer S.A., Madrid, Spain
  1. Correspondence to Dr. Javier Soto Alvarez, HEOR, Pfizer Spain, Alcobendas, Madrid 28108, Spain; Javier.soto.alvarez{at}pfizer.com

Abstract

Objectives The study aimed to estimate the burden of metastatic breast cancer (mBC) in Spain over 5 years.

Methods An incidence-based cost-of-illness model was developed in which a cohort of patients with mBC was followed from the diagnosis of metastatic disease over 5 years or death. Resource use data were collected through a physician survey conducted with 10 clinical experts in Spain. The model distinguished patients according to HER2 and hormonal receptor (HR) status, and followed the patient cohort in monthly cycles.

Results The incident cohort was estimated to be 2,923 patients with mBC, consisting of 1,575 HER2−/HR+, 520 HER2+/HR+, 324 HER2+/HR−, and 503 triple negative patients. The estimated mean survival over the 5-year time period was 2.51 years, on average, with longer survival of 3.36 years for HER2+/HR+, 2.41 years for HER2−/HR+, 2.82 years for HER2+/HR− and shortest mean survival of 1.74 years for triple negative patients. The total costs were €469,92,731 for the overall population, €190,079,787 for the HER2-/HR+, €151,045,260 for the HER2+/HR+, €80,827,171 for the HER2+/HR- and €47,540,512 for the triple negative subgroups over 5 years. Per patient total costs were €160,642 on average, €120,664 for HER2-/HR+, €290,346 for HER2+/HR+, €249,152 for HER2+/HR−and €94,572 for triple negative patients over 5 years.

Conclusions The economic burden of mBC in Spain is significant, but differs by HER2 and HR status. HER2−/HR +patients account for the highest burden due to the prevalence of this category, but HER2+/HR +patients have the highest per patient costs.

  • metastatic breast cancer
  • costs of illness
  • treatment patterns
  • direct costs
  • resource utilisation

https://doi.org/10.1136/ejhpharm-2017-001453

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