Tackling the high economic impact of recurrence in resected Medicare patients with early-stage triple-negative breast cancer.

Abstract

e13581 Background: Patients with resected triple negative breast cancer who experience recurrence have poorer survival outcomes, but the economic impact of recurrence is not well understood. This study assessed the additional healthcare resource use and costs associated with recurrence in Medicare patients with resected triple negative breast cancer. Methods: This retrospective cross-sectional study used Surveillance, Epidemiology, and End Results (SEER) cancer registry data linked with CMS Medicare claims. Eligible patients were aged 50 and older, with newly diagnosed triple negative breast cancer stages IB to IIIA (AJCC Staging Manual, 9th edition) and surgery between January 2015 and December 2019. Continuous enrollment criteria were applied to ensure complete data capture. Per patient per month (PPPM) healthcare utilization and all-cause direct costs were compared between patients with and without recurrence, identified through diagnosis, procedure, or drug codes. Patients were matched (1:1) by cancer stage and treatment, with additional matching on other characteristics using propensity scores. Results: Of the 5,673 patients, 2,610 (46%) had recurrence. After matching, each cohort included 1,600 patients. Those with recurrence had significantly higher healthcare utilization, including inpatient visits (+0.37 PPPM), outpatient visits (+2.25 PPPM), physician services (+4.70 PPPM), and emergency department visits (+0.67 PPPM; all p < 0.001). The average follow-up cost per patient per month (PPPM) was $8,893 for the recurrence cohort and $2,521 for the no-recurrence cohort, resulting in a $6,372 PPPM difference (p < 0.001), with inpatient costs being the largest contributor. Conclusions: In a real-world population, recurrence in patients with resected triple negative breast cancer is strongly linked to higher healthcare resource utilization and significantly increased costs. This underscores the need for prospective study design and we are addressing a global analysis.