Costs associated with Eribulin treatment for patients with metastatic breast cancer in a comprehensive cancer center in France

• Median overall survival in breast cancer patients treated with Eribulin is 10.7 months.
• Independent prognostic factors are PS, number of metastatic sites and hospitalization requirement.
• Eribulin administration contributes to 79% of per-patient costs.
• Eribulin cost effectiveness is uncertain in very advanced BC patients.
• Prescription of Eribulin should be validated by multidisciplinary oncology teams.

BackgroundThere is no standard recommendation for metastatic breast cancer treatment (MBC) after two chemotherapy regimens. Eribulin (Halaven®) has shown a significant improvement in overall survival (OS) in this setting. Its use may however be hampered by its cost, which is up to three times the cost of other standard drugs. We report the clinical outcomes and health care costs of a large series of consecutive MBC patients treated with Eribulin.MethodsA monocentric retrospective study was conducted at Institut Curie over 1 year (August 2012 to August 2013). Data from patient's medical records were extracted to estimate treatment and outcome patterns, and direct medical costs until the end of treatment were measured. Factors affecting cost variability were identified by multiple linear regressions and factors linked to OS by a multivariate Cox model.ResultsWe included 87 MBC patients. The median OS was 10.7 months (95%CI = 8.0–13.3). By multivariate Cox analysis, independent factors of poor prognosis were an Eastern Cooperative Oncology Group (ECOG) performance status of 3, a number of metastatic sites ≥ 4 and the need for hospitalization. Per-patient costs during whole treatment were €18,694 [CI 95%: 16,028–21,360], and €2581 [CI 95%: 2226–3038] per month. Eribulin administration contributed to 79% of per-patient costs.ConclusionsInnovative and expensive drugs often appear to be the main cost drivers in cancer treatment, particularly for MBC. There is an urgent need to assess clinical practice benefits.