Adverse events (AEs) may be a driver of high health care costs in patients with metastatic breast cancer treated with systemic therapy, according to a new study.
AEs are a serious concern for patients and providers, as they can significantly reduce one’s quality of life and, in serious instances, be a cause for discontinuing treatment, leading to worse overall outcomes. Further, the need for additional treatments and care strategies to manage AEs can be a significant driver of health care costs, though this effect has not been studied in depth.
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In a study published in the Journal of Medical Economics, researchers led by Debra E Irwin, PhD, Truven Health Analytics (Durham, NC), quantified AE-related costs in a population of patients with breast cancer. They looked at insurance claims data extracted from the Truven Health MarketScan® Multi-State Medicaid database for adult women treated with biologic or chemotherapy for metastatic breast cancer between 2006 and 2013. In these women, they estimated the average number of AEs (per 100 person years), the average monthly AE-related health care costs (per-patient-per-month), and total all-cause health care costs using multivariable regression in order to determine the association between rising costs and AEs.
Among the 729 patients identified for analysis, hematological (anemia, thrombocytopenia, etc) and constitutional (fatigue, diarrhea, etc) AEs were the most commonly reported (202.3 per 100 patient years and 289.6 per 100 patient years). Unadjusted per-patient-per-month AE-related costs were highest for hematological class events ($1524), followed by gastrointestinal ($839) and constitutional ($795) events. The specific AEs with the highest associated costs were anemia ($942), nausea/vomiting ($699), and leukopenia/neutropenia ($550).
In addition, researchers also found that monthly costs grew with the number of reported AEs. Patients who reported more than seven AEs ($19,701), four to six AEs ($16,264), and one to three AEs ($13,731) all had significantly higher costs than those who experienced no AEs ($5908).
Researchers concluded that the cost of care associated with systemic therapy for patients with metastatic breast cancer can rise significantly if patients experience a high number of AEs. Therefore, therapies that have been shown to cause fewer AEs may reduce cost burdens and improve patient outcomes.
