The economic burden of metastatic breast cancer: a U.S. managed care perspective

This study was performed to quantify the economic burden and identify drivers of direct costs of mBC. In a retrospective study of a de-identified administrative claims database of privately insured patients, women between 18 and 64 years of age were included if they had at least one claim with a diagnosis of breast cancer and subsequently one or more claims with a diagnosis of secondary malignancy between January 1, 2003 and December 31, 2009. The study sample was further classified into the following subgroups: (1) Endocrine therapy, (2) HER-2 targeted therapy, (3) Concomitant HER-2 targeted and endocrine therapy, (4) Cytotoxic chemotherapy, and (5) No-systemic therapy. Costs for medical resource utilization were calculated on a per patient per month (PPPM) basis. A total of 7,698 mBC patients were identified from 2003 to 2009 with an average age at index of similar to 52 years, and average follow up of 2.2 years. The average total direct medical costs for 7,698 mBC patients were $9,788 PPPM. Outpatient costs accounted for the majority of overall PPPM costs. Examining the five different mBC therapeutic subgroups revealed that patients who received no-systemic therapy had the highest costs at $13,926 PPPM, while patients who received systemic endocrine therapy had the lowest costs at $5,303 PPPM. This study demonstrated that mBC is associated with substantial healthcare costs in a non-Medicare patient population. Assuming average PPPM costs of $9,788 and an average life expectancy of 2.2 years, the total average expenditure to treat mBC would be similar to$250,000 per patient.