Economic/societal burden of metastatic breast cancer: a US perspective

To review the issues surrounding the economic and societal burden of metastatic breast cancer to provide a context for understanding the value of newly introduced high-cost drug treatments.

The PubMed database and relevant congress abstract databases were searched to identify cost-of-illness data with relevance to metastatic breast cancer and the cost of therapies emerging within the last 5 years.

The direct costs alone have been estimated to be $4.2 billion per year in the United States (1998 dollars), but more data are needed on the indirect and total societal costs associated with advanced disease. Of the new high-cost anticancer drugs introduced in the last 5 years, cost-effectiveness analyses have been reported only for lapatinib and ixabepilone in the United States. Both drugs showed high incremental cost-effectiveness ratios, although the estimated budget impact of ixabepilone was minimal due to expected low utilization in its approved indications. These studies did not include the broader indirect and full societal costs that could potentially be lowered by effective treatment.

The most current estimates of direct costs for metastatic breast cancer do not represent the full societal impact of the disease. Further research is needed to fully understand how different treatment options for metastatic breast cancer affect overall societal costs in the United States, and how outcomes in the palliative setting are valued by society.