Cost of disease progression among US patients with human epidermal growth factor receptor 2-positive metastatic breast cancer

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-04-22 DOI:10.57264/cer-2023-0166

Clara Lam, Brandon J Diessner, Katherine Andrade, Sydnie Stackland, Leah Park, Sandhya Mehta, Feng Lin, Winghan Jackie Kwong

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Abstract

Aim: The objectives were to investigate the differences in per patient per month (PPPM) healthcare resource utilization (HCRU) and costs among commercially insured and Medicare Advantage patients with human epidermal growth factor receptor 2 positive (HER2+) metastatic breast cancer (mBC) who experience disease progression in 12 months compared with those who don't investigate the impact of progression timing on cumulative healthcare costs. Patients & methods: This claims-based study included patients diagnosed with mBC between 1 January 2013 and 30 April 2020 and received HER2-targeted therapy. Patients were categorized as progressed or nonprogressed. For objective one, monthly HCRU and costs were assessed for up to two lines of therapy (LOTs). Data were summarized descriptively and compared using a generalized linear model (GLM). For objective two, patients with at least 6 months of follow-up were assessed and cumulative healthcare costs were estimated in the 3 years following the start of LOT1 or LOT2 using a GLM and Kaplan–Meier weighting. Results: Among the 4113 patients in the study sample, 3406 had at least 12 months of follow-up (or less if due to death). Compared with nonprogressed patients, progressed patients had higher mean PPPM healthcare costs (LOT1: $22,014 vs $18,372, p < 0.001; LOT2: $19,643 vs $16,863, p = 0.001), and HCRU, including number of emergency room visits and inpatient stays (both p < 0.001) in the 12 months following LOT start. Progressed patients had higher 3-year mean cumulative healthcare costs than nonprogressed patients following LOT1 and LOT2 and this difference was greater for patients who progressed earlier. Conclusion: Disease progression was associated with significant increases in HCRU and costs. Delays in progression were associated with lower cumulative healthcare costs. Earlier use of more clinically effective treatments to delay progression may reduce the economic burden among these patients.

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美国人类表皮生长因子受体 2 阳性转移性乳腺癌患者的疾病进展成本

目的：该研究旨在调查人表皮生长因子受体 2 阳性（HER2+）转移性乳腺癌（mBC）商业保险和医疗保险优势患者在 12 个月内出现疾病进展与未出现疾病进展的患者相比，每位患者每月医疗资源利用率（PPPM）和费用的差异，并调查疾病进展时间对累计医疗费用的影响。患者与方法：这项基于理赔的研究纳入了 2013 年 1 月 1 日至 2020 年 4 月 30 日期间确诊为 mBC 并接受 HER2 靶向治疗的患者。患者被分为进展期和非进展期。对于目标 1，评估了最多两条治疗线 (LOT) 的每月 HCRU 和费用。对数据进行描述性总结，并使用广义线性模型（GLM）进行比较。目标二：对随访至少 6 个月的患者进行评估，并使用 GLM 和 Kaplan-Meier 加权法估算 LOT1 或 LOT2 开始后 3 年内的累计医疗费用。结果在研究样本的 4113 名患者中，有 3406 名患者接受了至少 12 个月的随访（如果死亡，则随访时间更短）。与非进展期患者相比，进展期患者的平均 PPPM 医疗费用更高（LOT1：22,014 美元 vs 18,372 美元，p < 0.001；LOT2：19,643 美元 vs 16,863 美元，p = 0.001），在 LOT 开始后的 12 个月内，HCRU（包括急诊就诊次数和住院次数）也更高（两者均 p < 0.001）。在 LOT1 和 LOT2 后，进展期患者的 3 年平均累计医疗费用高于非进展期患者，且进展较早的患者的差异更大。结论：疾病进展与 HCRU 和费用的显著增加有关。推迟病情进展与降低累计医疗费用有关。尽早使用临床上更有效的治疗方法来延缓病情恶化可能会减轻这些患者的经济负担。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.