A population-based comparison of treatment patterns, resource utilization, and costs by cancer stage for Ontario patients with hormone receptor-positive/HER2-negative breast cancer.

ABSTRACT:

Purpose

To update and expand on data related to treatment, resource utilization, and costs by cancer stage in Canadian patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) breast cancer (BC).

Methods

We analyzed data for adult women diagnosed with invasive HR+/HER2- BC between 2012 and 2016 utilizing the publicly funded health care system in Ontario. Baseline characteristics, treatment received, and health care use were descriptively compared by cancer stage (I-III vs. IV). Resource use was multiplied by unit costs for publicly funded health care services to calculate costs.

Results

Our study included 21,360 patients with stage I-III plus 813 with stage IV HR+/HER2- BC. Surgery was performed on 20,510 patients with stage I-III disease (96.0%), with the majority having a lumpectomy, and radiation was received by 15,934 (74.6%). Few (n?=?1601, 7.8%) received neoadjuvant and most (n?=?15,655, 76.3%) received adjuvant systemic treatment. Seven hundred and fifty eight patients with metastatic disease (93.2%) received systemic therapy; 542 (66.7%) received endocrine therapy. Annual per patient health care costs were three times higher in the stage IV vs. stage I-III cohort with inpatient hospital services representing nearly 40% of total costs.

Conclusion

The costs associated with metastatic HR+/HER2- BC reflect a significant disease burden. Low endocrine treatment rates captured by the publicly funded system suggest guideline non-adherence or that a fair portion of Ontarian patients may be incurring out-of-pocket drug costs.

SUBMITTER: Brezden-Masley C 

PROVIDER: S-EPMC7867554 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature