Direct Medical Costs of Advanced Breast Cancer Treatment: A Real-World Study in the Southeast of The Netherlands

Abstract

categories and the lifetime costs per patient, adjusted for censoring using Lin's method. The relationship between patients' characteristics and costs was studied using multivariable regression. Results: The average (SE) lifetime hospital costs of patients with advanced breast cancer were V52 709 (405). Costs differed considerably between patient subgroups, ranging from V29 803 for patients with a triple-negative subtype to V92 272 for patients with hormone receptor positive and human epidermal growth factor receptor 2 positive cancer. Apart from the cancer subtype, several other factors, including age and survival time, were independently associated with patient lifetime costs. Overall, a large share of costs was attributed to systemic therapies (56%), predominantly to a few expensive agents, such as trastuzumab (15%), everolimus (10%), and bevacizumab (9%), as well as to inpatient hospital days (20%). Conclusions: This real-world study shows the high degree of variability in hospital resource use and associated costs in advanced breast cancer care. The presented resource use and costs data provide researchers and policy makers with key figures for economic evaluations and budget impact analyses.

Capturing the True Cost of Breast Cancer Treatment: Molecular Subtype and Stage-Specific per-Case Activity-Based Costing

“…The 10-year Medicare cost (2007–2016) of treating stage I BC was USD 136,428 and that for stage IV was USD 376,563, with cost being exponentially related to stage [ 56 ]. A 2021 micro-costing Netherlands model for lifetime hospital costs for advanced BC found an average cost of € 52,709 (C$ 77,482) ranging from € 29,803 (C$ 43,810) in TN to € 92,272 (C$ 135,639) in HR+/HER2+ BC [ 57 ]. A 2022 US time-based ABC did not present integrated case costs by treatment possibility, stage and subtype, but derived similar costs [ 58 ].…”

Cost-effectiveness of 2-[18F]FDG-PET/CT versus CE-CT for response monitoring in patients with metastatic breast cancer: a register-based comparative study

“…They concluded that 2-[ 18 F]FDG-PET/CT was a cost-effective modality in the Netherlands and US, but not in the UK due to varying costs of services and different healthcare policies 28 . The average lifetime hospital-based costs of patients with advanced breast cancer was reported to be around €53,000 in the Netherlands 29 . The Dutch Council for Public Health and Health Care has set an informal ceiling ratio of €80,000 per gained extra year of survival for cancer patients, which could grant the use of 2-[ 18 F]FDG-PET/CT for response monitoring of MBC patients 10 , 30 .…”