Abstract
Breast cancer is the second most diagnosed cancer in Australia. The management of early breast cancer (EBC) has significantly evolved over the past decade - from adjuvant chemotherapy, hormonal therapy and trastuzumab, to the inclusion of neoadjuvant chemotherapy, escalated endocrine therapies, novel targeted therapies and immunotherapy. Just in the past 3 years, we have seen the Pharmaceutical Benefits Scheme listings of Olaparib (July 2024), Abemaciclib (May 2024), Zoledronic acid (December 2023), and Pembrolizumab (December 2023), which has seen the improvement in survival outcomes for patients with high risk EBC. However, there is a lack of assessment of the effect on resource requirements in our cancer care services from these advances.
Aim
This study aims to compare the healthcare requirements in the medical oncological management of EBC in Australia over the past decade.
Methods
The quantification of the health system utilisation is through the approximation of clinical care events (CCE) based on current standard of care for the management of patients with high risk EBC. CCE include provision of systemic treatments at an infusion centre and clinical reviews. Data from medical records of EBC patients diagnosed in 2013 compared to 2023 in a teaching hospital in Sydney, Australia.
Results
For hormone receptor-positive EBC, there were 29 CCE in 2013 and 67 in 2023 (131% increase). For triple negative EBC, there were 24 CCE in 2013 and 70 in 2023, (192% increase). Interestingly, for HER2 positive EBC, there were 46 CCE in 2013 and 33 in 2023 (28.2% decrease).
Conclusions
Advances in the management of EBC has led to improved survival outcomes for patients with high-risk disease. However, this has led to increased health care service utilisation. Healthcare implementation strategies are required to meet the ongoing demand of cancer care services to maintain quality patient care.