PMID- 27206801
OWN - NLM
STAT- MEDLINE
DCOM- 20170629
LR  - 20170629
IS  - 1941-837X (Electronic)
IS  - 1369-6998 (Linking)
VI  - 19
IP  - 11
DP  - 2016 Nov
TI  - Adverse event-related costs for systemic metastatic breast cancer treatment among 
      female Medicaid beneficiaries.
PG  - 1027-1033
AB  - OBJECTIVE: This retrospective study compared the real-world incidence and costs 
      of systemic treatment-related adverse events (AEs) in patients with metastatic 
      breast cancer in a Medicaid population. METHODS: Insurance claims data for adult 
      women who received biologic or chemotherapy (+/- hormonal therapy) for metastatic 
      breast cancer between 2006-2013 were extracted from the Truven Health 
      MarketScan((R)) Multi-State Medicaid database. Incidence of AEs (per 100 person 
      years) and average monthly AE-related healthcare costs (per-patient-per-month) 
      during each line of therapy (first or later lines) were estimated. The 
      association between AEs and total all-cause healthcare costs was estimated using 
      multivariable regression. RESULTS: A total of 729 metastatic breast cancer 
      patients were analyzed. Hematological (202.3 per 100 person years) and 
      constitutional AEs (289.6 per 100 person years) were the most common class of AEs 
      reported. Unadjusted per-patient-per-month AE-related expenditure by class were 
      highest for hematological AEs ($1524), followed by gastrointestinal ($839) and 
      constitutional AEs ($795), with anemia ($942), nausea/vomiting ($699), and 
      leukopenia/neutropenia ($550) having incurred the highest total AE-related costs. 
      Adjusted total all-cause monthly costs increased with the number of AEs ($19,701 
      for >7 AEs, $16,264 for 4 - 6 AEs, and $13,731 for 1 - 3 AEs) compared to no AEs 
      ($5908) (all p < 0.01). CONCLUSIONS: Among metastatic breast cancer patients 
      treated with systemic therapy in a Medicaid population, AEs were associated with 
      significant increases in costs, which increased with the number of AEs 
      experienced. Therapies associated with a lower incidence of AEs may reduce cost 
      burden and improve patient outcomes.
FAU - Irwin, Debra E
AU  - Irwin DE
AD  - a Truven Health Analytics , Durham , NC , USA.
FAU - Masaquel, Anthony
AU  - Masaquel A
AD  - b Genentech, Inc. , South San Francisco , CA , USA.
FAU - Johnston, Stephen
AU  - Johnston S
AD  - c Truven Health Analytics , Bethesda , MD , USA.
FAU - Barnett, Brian
AU  - Barnett B
AD  - b Genentech, Inc. , South San Francisco , CA , USA.
LA  - eng
PT  - Journal Article
DEP - 20160607
PL  - England
TA  - J Med Econ
JT  - Journal of medical economics
JID - 9892255
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antineoplastic Agents/*adverse effects/*therapeutic use
MH  - Breast Neoplasms/*drug therapy
MH  - Databases, Factual
MH  - Drug-Related Side Effects and Adverse Reactions/*economics
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Insurance Claim Review
MH  - *Medicaid
MH  - Middle Aged
MH  - *Neoplasm Metastasis
MH  - Retrospective Studies
MH  - United States
MH  - Young Adult
OTO - NOTNLM
OT  - Adverse events
OT  - Breast cancer
OT  - Healthcare costs
OT  - Medicaid
OT  - Systemic therapy
EDAT- 2016/10/18 06:00
MHDA- 2017/07/01 06:00
CRDT- 2016/05/22 06:00
PHST- 2016/10/18 06:00 [pubmed]
PHST- 2017/07/01 06:00 [medline]
PHST- 2016/05/22 06:00 [entrez]
AID - 10.1080/13696998.2016.1192548 [doi]
PST - ppublish
SO  - J Med Econ. 2016 Nov;19(11):1027-1033. doi: 10.1080/13696998.2016.1192548. Epub 
      2016 Jun 7.