Healthcare costs in postmenopausal women with hormone-positive metastatic breast cancer.
OBJECTIVE
This study examines costs for postmenopausal women with hormone receptor positive (HR+) metastatic breast cancer (mBC).


METHODS
Data were obtained from the IHCIS National Managed Care Benchmark Database from 1/1/2001 to 6/30/2006. Women aged 55-63 years were selected for the study if they met the inclusion criteria, including diagnoses for breast cancer and metastases, and at least two fills for a hormone medication. Patients were followed from the onset of metastases until the earliest date of disenrollment from the health plan or 6/30/2006. Patient characteristics were examined at time of initial diagnoses of metastases, while costs were examined post-diagnosis of metastases and prior to receipt of chemotherapy (pre-chemotherapy initiation period) and from the date of initial receipt of chemotherapy until end of data collection (post-chemotherapy initiation period). Costs were adjusted to account for censoring of the data.


RESULTS
The study population consisted of 1,266 women; mean (SD) age was 59.05 (2.57) years. Pre-chemotherapy initiation, unadjusted inpatient, outpatient, and drug costs were $4,392, $47,731, and $5,511, while these costs were $4,590, $57,820, and $38,936 per year, respectively, post-chemotherapy initiation. After adjusting for censoring of data, total medical costs were estimated to be $55,555 and $70,587 in the first 12 months and 18 months, respectively in the pre-chemotherapy initiation period. Post-chemotherapy initiation period, 12-month and 18-month adjusted total medical costs were estimated to be $87,638 and $130,738.


CONCLUSIONS
The use of an administrative claims database necessitates a reliance upon diagnostic codes, age restrictions, and medication use, rather than formal assessments to identify patients with post-hormonal women with breast cancer. Furthermore, such populations of insured patients may not be generalizable to the population as a whole.


CONCLUSIONS
These findings suggest that healthcare resource use and costs - especially in the outpatient setting - are high among women with HR+ metastatic breast cancer.
HealthMetrics Outcomes Research, Groton, CT 06340, USA. lagemj@hlthmetrics.com
Maureen J
MJ
Lage
Rohit
R
Borker
Beth
B
Barber
Sue
S
Gao
D018931:Antineoplastic Agents, Hormonal / Q000191:economics / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000191:economics* / Q000473:pathology / Q000628:therapy; D004636:Emergency Service, Hospital / Q000191:economics; D005252:Fees, Pharmaceutical / Q000706:statistics & numerical data; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008875:Middle Aged; D018803:Models, Economic; D009362:Neoplasm Metastasis; D009376:Neoplasms, Hormone-Dependent / Q000191:economics* / Q000473:pathology / Q000628:therapy; D010045:Outpatients / Q000706:statistics & numerical data; D017698:Postmenopause; D013997:Time Factors
D018931:Antineoplastic Agents, Hormonal