Use of Data-Mining to Support Real-World Cost Analyses: An Example Using Her2-Positive Breast Cancer in Iran Publisher Pubmed



Ansaripour A¹ ; Zendehdel K² ; Tadayon N³ ; Sadeghi F² ; Groot CAU¹ ; Ken Redekop W¹
Source: PLoS ONE Published:2018

Abstract

Introduction Patient registries play an important role in obtaining real-world evidence of the cost-effectiveness of treatments. However, their implementation is costly and sometimes infeasible in many middle-income countries (MICs). We explored the combination of data-mining and a large claims database to estimate the direct healthcare costs of HER2-positive breast cancer (BC) treatment in Iran and the fraction of total costs from trastuzumab use. Method We performed a retrospective analysis of claims data from the Iran Social Security Organization, a health insurer which covers approximately 50%(~40 million) of the Iranian population, in the period of 21/03/2011-20/03/2014. A data-mining algorithm using R software and validated using patient dossiers in the Cancer Research Center identified 1295 patients and divided them into the three main HER2-positive breast cancer stages (early, loco-regional and advanced). A payer perspective was used to calculate the absolute and relative direct costs of healthcare services associated with the treatment of HER2-positive breast cancer in the public and private healthcare systems. Results The number of women totaled 802 (early), 125 (loco-regional) and 218 (advanced). The mean age[SD] was 45[10], 46[10] and 48[10] years, respectively, while mean follow-up in all stages was approximately one year. Average costs of direct healthcare care in early, locoregional and advanced stages were ∈11,796 (95%CI: ∈9,356-∈12,498), ∈8,253 (95%CI: ∈6,843-∈10,002), and ∈17,742 (95%CI: ∈15,720-∈19,505), respectively. Trastuzumab accounted for the largest share of total costs in all three stages (range: 53-76%). Conclusion Wherever comprehensive patient registries are infeasible or costly, real-world costs can be estimated through claims databases and data-mining strategies. Using this method, realworld costs have been estimated in Iran. The stage-specific cost estimates derived from this study can be used to perform real-world cost-effectiveness analyses of therapies for HER2- positive BC and support healthcare financing decisions. © 2018 Ansaripour et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.