Impact of brain metastases on health care costs in metastatic breast cancer: A multinational study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6555-6555
Author(s):  
M. D. Walker ◽  
K. Lykopoulos ◽  
E. McLeod ◽  
S. Cottrell ◽  
L. Christova
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Metastatic Breast Cancer ◽  
Brain Metastases ◽  
Health Care Costs ◽  
Financial Burden ◽  
Metastatic Breast ◽  
Her2 Breast Cancer ◽  
The Uk ◽  
Care Costs

6555 Background: Incidence of brain metastases (BM) are thought to be particularly high among patients with ErbB2+ (HER2+) breast cancer and have been associated with a poor survival prognosis. A previous study identified such patients as a considerable financial burden for health systems in Germany and France when compared to metastatic breast cancer (MBC) without BM. The objective of this study was to extend that analysis to estimate health care costs in Italy, Spain and the UK. Methods: Patient treatment histories, including drugs, specialist visits, procedures, inpatient stays etc, were collected retrospectively from a panel of oncologists for women with MBC across Italy, Spain and the UK, last seen by the responding oncologist during Q3-Q4 2006 or Q3-Q4 2007. To identify ErbB2+ patients they all had to have received/were receiving trastuzumab (TZ) for MBC. Patients were sampled so as to ensure the collection contained a minimum of 50 cases with BM and 200 histories overall (remainder controls). All costs within the observation period (initiation of TZ to date last seen) were calculated from a payer's perspective for patients who had developed BM and those who had not. Linear stepwise regression took into account potential confounding of time related covariates. Results: The study included 268 Italian (146 cases), 215 Spanish (126 cases) and 243 UK patients (103 cases). BM diagnosis was associated with significantly more expensive treatment histories than those patients without. Service costs such as radiotherapy and hospital visits were found to be key drivers for these differences (p<.001). Conclusions: The significantly greater cost associated with treatment of BMs in ErbB2+ MBC patients from Italy, Spain and the UK is consistent with results from identical French and German analyses. Therapies that reduce the incidence of BMs may therefore decrease the overall financial burden of ErbB2+ MBC. [Table: see text] [Table: see text]

Very low-dose warfarin prophylaxis to prevent thromboembolism in women with metastatic breast cancer receiving chemotherapy: an economic evaluation.

1995 ◽  
Vol 13 (1) ◽  
pp. 42-46 ◽  
Author(s):  
R Rajan ◽  
A Gafni ◽  
M Levine ◽  
J Hirsh ◽  
M Gent
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Metastatic Breast Cancer ◽  
Health Care System ◽  
Health Care Costs ◽  
Low Dose ◽  
Metastatic Breast ◽  
Dose Warfarin ◽  
The Cost ◽  
Care Costs

PURPOSE A recent double-blind, randomized trial demonstrated that very low-dose warfarin (VLDW) reduced the incidence of venous thromboembolism (VTE) without increasing the rate of bleeding in women with metastatic breast cancer receiving chemotherapy. We have evaluated the economic impact on the health care system of using VLDW in such patients. METHODS The records of patients entered onto the trial and a simultaneous, fully allocated, costing model for a tertiary care hospital in Hamilton, Canada were used to determine the difference in costs associated with the care of patients with and without VLDW. RESULTS The cost of providing VLDW was $ 21,854 (Canadian dollars) per 100 patients. This therapy led to a reduction in costs of $ 24,297 per 100 patients, thus saving the health care system $ 2,443 per 100 patients. In the sensitivity analysis, VLDW prophylaxis still did not increase health care costs unless the cost of VLDW was greatly increased, the cost of treating thromboembolic episodes was markedly reduced, or the incidence of either VTE or bleeding with VLDW was increased above the rates observed in the trial. CONCLUSION We conclude that for women receiving chemotherapy for metastatic breast cancer, the benefits of VLDW can be realized without increased health care costs.

Risk and health care costs of chemotherapy-induced neutropenic complications in women with metastatic breast cancer.

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. 1050-1050
Author(s):  
D. Weycker ◽  
J. Edelsberg ◽  
A. Kartashov ◽  
R. Barron ◽  
G. H. Lyman
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Metastatic Breast Cancer ◽  
Health Care Costs ◽  
Metastatic Breast ◽  
Care Costs

scholarly journals PCN41 Hospital Health Care Costs for the Management of HER2-Positive Breast Cancer with Brain Metastases

2011 ◽  
Vol 14 (7) ◽  
pp. A441
Author(s):  
S. Baffert ◽  
P. Cottu ◽  
Y. Kirova ◽  
T. Bachelot ◽  
F. Mercier ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Brain Metastases ◽  
Health Care Costs ◽  
Her2 Positive ◽  
Her2 Positive Breast Cancer ◽  
Care Costs ◽  
Positive Breast Cancer

Updated results of tucatinib versus placebo added to trastuzumab and capecitabine for patients with pretreated HER2+ metastatic breast cancer with and without brain metastases (HER2CLIMB).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1043-1043
Author(s):  
Giuseppe Curigliano ◽  
Volkmar Mueller ◽  
Virginia F. Borges ◽  
Erika P. Hamilton ◽  
Sara A. Hurvitz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Brain Metastases ◽  
Kinase Inhibitor ◽  
Locally Advanced ◽  
Metastatic Breast ◽  
Total Study Population ◽  
Her2 Breast Cancer ◽  
Metastatic Setting ◽  
To Receive

1043 Background: Tucatinib (TUC) is an oral tyrosine kinase inhibitor (TKI) highly specific for HER2. TUC is approved for use in combination with trastuzumab (T) and capecitabine (C) in patients (pts) with and without brain metastases (BM) who have received 1 or more prior anti-HER2–based regimens in the metastatic setting. In the primary analysis from the pivotal HER2CLIMB trial, the addition of TUC to T and C in pts with HER2+ metastatic breast cancer showed a statistically significant and clinically meaningful prolongation of progression-free (PFS) (HR = 0.54 [95% CI: 0.42, 0.71]; P < 0.001) and overall survival (OS) (HR = 0.66 [95% CI: 0.50, 0.88]; P = 0.005) (Murthy, et al. NEJM 2020). TUC in combination with T and C was well tolerated with few discontinuations other than for disease progression. Based on these data, the protocol was amended for unblinding of sites to treatment assignment to allow for crossover from the placebo arm to receive TUC in combination with T and C. Methods: HER2CLIMB (NCT02614794) is a global, randomized, double-blind, placebo-controlled trial in pts with unresectable locally advanced or metastatic HER2+ breast cancer previously treated with T, pertuzumab, and T-emtansine (T-DM1), including pts with untreated, treated stable, or treated and progressing BM. Overall 612 pts were randomized 2:1 to receive TUC 300 mg BID or placebo, each in combination with T and C. Randomization was stratified by BM, ECOG performance status, and geographic region. Protocol prespecified analysis of OS, PFS (by investigator assessment) and safety in the total study population will be performed at approximately 2 years from the last patient randomized. Results: Updated Kaplan-Meier time-to-event analysis of OS and PFS with hazard ratios and 95% confidence intervals for TUC arm vs placebo arm will be presented overall, as well as for OS in the prespecified subgroups reported previously (Murthy, et al. NEJM 2020). Safety and tolerability assessments will include frequency of adverse events by severity, dose modifications and discontinuation of study medications. Conclusions: Conclusions will be presented in the presentation. Clinical trial information: NCT02614794 .

scholarly journals Financial Resources Digital Navigation Tool for Metastatic Breast Cancer Patients

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 172s-172s
Author(s):  
C. Ammendolea ◽  
J. Gordon ◽  
W. Hall ◽  
R. Armstrong ◽  
N. Chari ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Financial Burden ◽  
Metastatic Breast ◽  
Advisory Board ◽  
Financial Resources ◽  
Breast Cancer Patients ◽  
Navigation Tool

Background and context: Although Canadians enjoy a universal health care system, there continues to be costs to patients that are not covered by the system. The economic impact of breast cancer is huge and, in many cases, devastating for patients and their families. As a result there is a need for educational and navigational resources that assist patients with the financial burden of facing a metastatic breast cancer diagnosis. Aim: The aim of this project is to develop an online navigation tool that will assist Canadians living with metastatic breast cancer source financial supports and resources to help lessen the financial impact of their diagnosis. Strategy/Tactics: An advisory board of people living with metastatic breast cancer was convened to help guide this project and provide input on the lived experience and financially challenges of Canadians living with this stage of the disease. The input from the advisory board along with the responses from a survey of over 150 Canadian metastatic breast cancer patients informed the type of information that should be included in the resource. Through an environmental scan and research of various financial supports, a comprehensive list of financial resources available locally, regionally and nationally was compiled. This data were integrated into a database that will be accessed through an intuitive online interface that will be integrated with CBCN´s Web site. The advisory board reviewed the draft content and framework to ensure that identified needs and priorities have been addressed. All content was translated into French as this tool will be offered in both French and English. The anticipated launch of this resource is November 2018. Outcomes: CBCN anticipates that over 1200 people living with metastatic breast cancer will access this resource in the first year and that over 50 institutions will be informed that this tool is available for their patients. Given that this will be a unique resource, CBCN expects that patients, health care professionals and support workers will access this resource to better support people living with metastatic breast cancer. What was learned: This resource has not launched, but based on CBCN´s research and the feedback of the patient advisory board, it is understood that there is a great need for this financial resources navigation tool.

scholarly journals The Incidence of Brain Metastases Among Patients with Metastatic Breast Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Markus Kuksis ◽  
Yizhuo Gao ◽  
William Tran ◽  
Christianne Hoey ◽  
Alex Kiss ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Metastatic Breast Cancer ◽  
Brain Metastases ◽  
Triple Negative ◽  
Screening Program ◽  
Meta Analysis ◽  
Metastatic Breast ◽  
Breast Cancer Brain Metastasis

Abstract Background Patients with metastatic breast cancer (MBC) are living longer, but development of brain metastases often limits their survival. We conducted a systematic review and meta-analysis to determine the incidence of brain metastases in this patient population. Methods Articles published from January 2000 to January 2020 were compiled from four databases using search terms related to: breast cancer, brain metastasis, and incidence. The overall and per patient-year incidence of brain metastases were extracted from studies including patients with HER2+, triple negative, and hormone receptor (HR)+/HER2- MBC; pooled overall estimates for incidence were calculated using random effects models. Results 937 articles were compiled, and 25 were included in the meta-analysis. Incidence of brain metastases in patients with HER2+ MBC, triple negative MBC, and HR+/HER2- MBC was reported in 17, 6, and 4 studies, respectively. The pooled cumulative incidence of brain metastases was 31% for the HER2+ subgroup (median follow-up: 30.7 months, IQR: 24.0 – 34.0), 32% for the triple negative subgroup (median follow-up: 32.8 months, IQR: 18.5 – 40.6), and 15% among patients with HR+/HER2- MBC (median follow-up: 33.0 months, IQR: 31.9 – 36.2). The corresponding incidences per patient-year were 0.13 (95% CI: 0.10 – 0.16) for the HER2+ subgroup, 0.13 (95%CI: 0.09 – 0.20) for the triple negative subgroup, and only 0.05 (95%CI: 0.03 – 0.08) for patients with HR+/HER2- MBC. Conclusion There is high incidence of brain metastases among patients with HER2+ and triple negative MBC. The utility of a brain metastases screening program warrants investigation in these populations.

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