title: Investigation of adverse-event-related costs for patients with metastatic breast cancer in a real-world setting.
abstract: BACKGROUND
  Existing treatments for metastatic breast cancer (mBC) are often effective but can cause adverse events (AEs). This study aimed to identify AEs associated with chemotherapies commonly used in mBC treatment (phase 1) and to quantify the economic impact of these AEs (phase 2).
  
  
  METHODS
  Patients in phase 1 had at least one claim for therapy for mBC, with at least one episode with single or multiple agents. The most common chemotherapy-related complications were identified using medical and pharmacy claims data. In phase 2, patients meeting study criteria were divided into four treatment cohorts by the line of treatment and chemotherapy received: first-line taxane-treated patients, second-line taxane-treated patients, first-line capecitabine-treated patients, and second-line capecitabine-treated patients. Average monthly AE-related health care costs per cohort were stratified by cost component. Total monthly costs per number of AEs were also calculated.
  
  
  RESULTS
  On average, patients in phase 1 (n = 1,551) had 2 episodes of treatment, with a mean duration of 131 days. The most frequently noted complications were anemia (50.7% of mBC treatment episodes), bilirubin elevation (26.4%), and leukopenia (24.8%). In phase 2, costs related to AEs were primarily driven by incremental inpatient, outpatient, and pharmacy costs. Increases in average monthly costs ranged from $854 (9.0%) to $5,320 (69.5%), according to cohort. Overall costs increased with increasing numbers of AEs.
  
  
  CONCLUSIONS
  Chemotherapy-related AEs in patients with mBC are associated with a substantial economic burden that increases with the number of AEs reported.
authors.affiliation: University of California Los Angeles, Los Angeles, California, USA; Analysis Group, Inc., Montreal, Quebec, Canada; Genentech Inc., South San Francisco, California, USA; Analysis Group, Inc., Boston, Massachusetts, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Hurvitz
authors.affiliation: University of California Los Angeles, Los Angeles, California, USA; Analysis Group, Inc., Montreal, Quebec, Canada; Genentech Inc., South San Francisco, California, USA; Analysis Group, Inc., Boston, Massachusetts, USA aguerin@analysisgroup.com.
authors.forename: Annie
authors.initials: A
authors.lastname: Guerin
authors.affiliation: University of California Los Angeles, Los Angeles, California, USA; Analysis Group, Inc., Montreal, Quebec, Canada; Genentech Inc., South San Francisco, California, USA; Analysis Group, Inc., Boston, Massachusetts, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Brammer
authors.affiliation: University of California Los Angeles, Los Angeles, California, USA; Analysis Group, Inc., Montreal, Quebec, Canada; Genentech Inc., South San Francisco, California, USA; Analysis Group, Inc., Boston, Massachusetts, USA.
authors.forename: Ellie
authors.initials: E
authors.lastname: Guardino
authors.affiliation: University of California Los Angeles, Los Angeles, California, USA; Analysis Group, Inc., Montreal, Quebec, Canada; Genentech Inc., South San Francisco, California, USA; Analysis Group, Inc., Boston, Massachusetts, USA.
authors.forename: Zheng-Yi
authors.initials: ZY
authors.lastname: Zhou
authors.affiliation: University of California Los Angeles, Los Angeles, California, USA; Analysis Group, Inc., Montreal, Quebec, Canada; Genentech Inc., South San Francisco, California, USA; Analysis Group, Inc., Boston, Massachusetts, USA.
authors.forename: Dominick
authors.initials: D
authors.lastname: Latremouille Viau
authors.affiliation: University of California Los Angeles, Los Angeles, California, USA; Analysis Group, Inc., Montreal, Quebec, Canada; Genentech Inc., South San Francisco, California, USA; Analysis Group, Inc., Boston, Massachusetts, USA.
authors.forename: Eric Q
authors.initials: EQ
authors.lastname: Wu
authors.affiliation: University of California Los Angeles, Los Angeles, California, USA; Analysis Group, Inc., Montreal, Quebec, Canada; Genentech Inc., South San Francisco, California, USA; Analysis Group, Inc., Boston, Massachusetts, USA.
authors.forename: Deepa
authors.initials: D
authors.lastname: Lalla
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D001952:Bridged-Ring Compounds / Q000191:economics / Q000627:therapeutic use; D000069287:Capecitabine; D003365:Costs and Cost Analysis / Q000191:economics*; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D064420:Drug-Related Side Effects and Adverse Reactions / Q000191:economics* / Q000453:epidemiology; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D017048:Health Care Costs; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D043823:Taxoids / Q000191:economics / Q000627:therapeutic use
chemical_list: D001952:Bridged-Ring Compounds; D043823:Taxoids; D003841:Deoxycytidine; C080625:taxane; D000069287:Capecitabine; D005472:Fluorouracil
keywords: Breast neoplasms; Costs and cost analysis; Drug-related side effects and adverse reactions; Neoplasm metastasis
references.citation: Pharmacoeconomics. 2009;27(3):199-209
references.pmid: 19354340
references.citation: J Clin Epidemiol. 1992 Jun;45(6):613-9
references.pmid: 1607900
references.citation: J Natl Cancer Inst. 2006 Aug 16;98(16):1108-17
references.pmid: 16912263
references.citation: Clin Colorectal Cancer. 2010 Oct;9(4):229-37
references.pmid: 20920995
references.citation: Multivariate Behav Res. 2011 May;46(3):399-424
references.pmid: 21818162
references.citation: Arch Pathol Lab Med. 2003 Jan;127(1):36-41
references.pmid: 12521364
references.citation: Cancer. 2009 Apr 1;115(7):1412-23
references.pmid: 19195048
references.citation: Pharmacotherapy. 2001 Jun;21(6):684-90
references.pmid: 11401182
references.citation: Chemotherapy. 2012;58(1):8-18
references.pmid: 22343254
references.citation: Springerplus. 2014 May 08;3:236
references.pmid: 24936383
references.citation: Med Care. 1999 Jun;37(6):601-14
references.pmid: 10386572
references.citation: Pharmacoeconomics. 2012 Sep 1;30(9):809-23
references.pmid: 22804805