Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system

Nazia Rashid,1 Han A Koh,2 Hilda C Baca,3 Kathy J Lin,1 Susan E Malecha,4 Anthony Masaquel5 1Drug Information Services, Kaiser Permanente, Downey, 2Southern California Permanente Medical Group, Kaiser Permanente, Bellflower, 3Pharmacy Analytical Services, Kaiser Permanente, Downey, 4US Medical Affai...

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Autores principales:	Rashid N, Koh HA, Baca HC, Lin KJ, Malecha SE, Masaquel A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	metastatic breast cancer chemotherapy adverse events costs healthcare use economic burden Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/73389797a360414a9392b3a3a342908e
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spelling	oai:doaj.org-article:73389797a360414a9392b3a3a342908e2021-12-02T00:45:47ZEconomic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system1179-1314https://doaj.org/article/73389797a360414a9392b3a3a342908e2016-10-01T00:00:00Zhttps://www.dovepress.com/economic-burden-related-to-chemotherapy-related-adverse-events-in-pati-peer-reviewed-article-BCTThttps://doaj.org/toc/1179-1314Nazia Rashid,1 Han A Koh,2 Hilda C Baca,3 Kathy J Lin,1 Susan E Malecha,4 Anthony Masaquel5 1Drug Information Services, Kaiser Permanente, Downey, 2Southern California Permanente Medical Group, Kaiser Permanente, Bellflower, 3Pharmacy Analytical Services, Kaiser Permanente, Downey, 4US Medical Affairs, Genetech Inc., San Francisco, 5Health Economics and Outcomes, Genentech Inc., San Francisco, CA, USA Background: Breast cancer is treated with many different modalities, including chemotherapy that can be given as a single agent or in combination. Patients often experience adverse events from chemotherapy during the cycles of treatment which can lead to economic burden.Objective: The objective of this study was to evaluate costs related to chemotherapy-related adverse events in patients with metastatic breast cancer (mBC) in an integrated health care delivery system.Methods: Patients with mBC newly initiated on chemotherapy were identified and the first infusion was defined as the index date. Patients were ≥18 years old at time of index date, had at least 6 months of health plan membership and drug eligibility prior to their index date. The chemotherapy adverse events were identified after the index date and during first line of chemotherapy. Episodes of care (EOC) were created using healthcare visits. Chart review was conducted to establish whether the adverse events were related to chemotherapy. Costs were calculated for each visit, including medications related to the adverse events, and aggregated to calculate the total EOC cost.Results: A total of 1,682 patients with mBC were identified after applying study criteria; 54% of these patients had one or more adverse events related to chemotherapy. After applying the EOC method, there were a total of 5,475 episodes (4,185 single episodes [76.4%] and 1,290 multiple episodes [23.6%]) related to chemotherapy-related adverse events. Within single episodes, hematological (1,387 EOC, 33.1%), musculoskeletal/pain related (1,070 EOC, 25.6%), and gastrointestinal (775 EOC, 18.5%) were the most frequent adverse events. Patients with adverse events related to single EOC with anemia and neutropenia had the highest total outpatient costs with 901 EOC ($81,991) and 187 EOC ($17,017); these patients also had highest total inpatient costs with 46 EOC ($542,798) and 16 EOC ($136,768). However, within multiple episodes, hematological (420 EOC, 32.6%), followed by infections/pyrexia (335 EOC, 25.9%) and gastrointestinal (278 EOC, 22.6%) were the most frequent adverse events.Conclusion: The economic burden related to chemotherapy adverse events in patients with mBC is substantial. Keywords: metastatic breast cancer, chemotherapy, adverse events, costs, health care use, economic burdenRashid NKoh HABaca HCLin KJMalecha SEMasaquel ADove Medical Pressarticlemetastatic breast cancerchemotherapyadverse eventscostshealthcare useeconomic burdenNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast Cancer: Targets and Therapy, Vol Volume 8, Pp 173-181 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	metastatic breast cancer chemotherapy adverse events costs healthcare use economic burden Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	metastatic breast cancer chemotherapy adverse events costs healthcare use economic burden Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Rashid N Koh HA Baca HC Lin KJ Malecha SE Masaquel A Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system
description	Nazia Rashid,1 Han A Koh,2 Hilda C Baca,3 Kathy J Lin,1 Susan E Malecha,4 Anthony Masaquel5 1Drug Information Services, Kaiser Permanente, Downey, 2Southern California Permanente Medical Group, Kaiser Permanente, Bellflower, 3Pharmacy Analytical Services, Kaiser Permanente, Downey, 4US Medical Affairs, Genetech Inc., San Francisco, 5Health Economics and Outcomes, Genentech Inc., San Francisco, CA, USA Background: Breast cancer is treated with many different modalities, including chemotherapy that can be given as a single agent or in combination. Patients often experience adverse events from chemotherapy during the cycles of treatment which can lead to economic burden.Objective: The objective of this study was to evaluate costs related to chemotherapy-related adverse events in patients with metastatic breast cancer (mBC) in an integrated health care delivery system.Methods: Patients with mBC newly initiated on chemotherapy were identified and the first infusion was defined as the index date. Patients were ≥18 years old at time of index date, had at least 6 months of health plan membership and drug eligibility prior to their index date. The chemotherapy adverse events were identified after the index date and during first line of chemotherapy. Episodes of care (EOC) were created using healthcare visits. Chart review was conducted to establish whether the adverse events were related to chemotherapy. Costs were calculated for each visit, including medications related to the adverse events, and aggregated to calculate the total EOC cost.Results: A total of 1,682 patients with mBC were identified after applying study criteria; 54% of these patients had one or more adverse events related to chemotherapy. After applying the EOC method, there were a total of 5,475 episodes (4,185 single episodes [76.4%] and 1,290 multiple episodes [23.6%]) related to chemotherapy-related adverse events. Within single episodes, hematological (1,387 EOC, 33.1%), musculoskeletal/pain related (1,070 EOC, 25.6%), and gastrointestinal (775 EOC, 18.5%) were the most frequent adverse events. Patients with adverse events related to single EOC with anemia and neutropenia had the highest total outpatient costs with 901 EOC ($81,991) and 187 EOC ($17,017); these patients also had highest total inpatient costs with 46 EOC ($542,798) and 16 EOC ($136,768). However, within multiple episodes, hematological (420 EOC, 32.6%), followed by infections/pyrexia (335 EOC, 25.9%) and gastrointestinal (278 EOC, 22.6%) were the most frequent adverse events.Conclusion: The economic burden related to chemotherapy adverse events in patients with mBC is substantial. Keywords: metastatic breast cancer, chemotherapy, adverse events, costs, health care use, economic burden
format	article
author	Rashid N Koh HA Baca HC Lin KJ Malecha SE Masaquel A
author_facet	Rashid N Koh HA Baca HC Lin KJ Malecha SE Masaquel A
author_sort	Rashid N
title	Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system
title_short	Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system
title_full	Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system
title_fullStr	Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system
title_full_unstemmed	Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system
title_sort	economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/73389797a360414a9392b3a3a342908e
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Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system

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