Direct medical cost of adjuvant systemic treatment for HER2-positive breast cancer in Vietnam

• Published in: Journal of pharmacy & pharmacognosy research 2025-01, Vol.13 (1), p.264-273
• Main Authors: Luu, Tram Nguyen Nguyet, Ngo, Hang Thu Thi, Ho, Xuan Dung, Phan, Quyen Do Thi, Truong, Thanh Viet, Nguyen, Lan Hoang, Nguyen, Chinh Van, Pham, Kiet Tuan Huy, Nguyen, Huong Thi Thanh
• Format: Article
• Language: English
• ISSN: 0719-4250; 0719-4250
• DOI: 10.56499/jppres24.2051_13.1.264

Context: HER2-positive breast cancer, one of the most aggressive subtypes of breast cancer, is associated with the high cost of HER2-targeted therapies. However, its financial burden in Vietnam has not been fully investigated. Aims: To determine the direct medical costs associated with HER2-positive breast cancer treatment in Vietnam from the perspective of healthcare payers, including social health insurance providers and patients. Methods: A multicenter study was conducted in two tertiary hospitals from January to December 2022. Retrospective patient-level data of 303 HER2-positive breast cancer patients who underwent adjuvant systemic treatment for initial treatment was analyzed. A micro-costing bottom-up approach was used to estimate the direct medical cost per inpatient admission in 2022. All cost calculations are presented as USD values using an exchange rate in 2022. Results: The average cost per inpatient admission was $680.0 ± $431.7. Of these, out-of-pocket costs accounted for approximately 42%. Drug costs were the main driver of total spending (92.9%), followed by hospital beds (2.2%), laboratory tests, and diagnostic imaging (2%). The cost of HER2-targeted therapy was responsible for 82.9% of the total direct medical cost. The average cost per inpatient admission of patients receiving chemotherapy with anti-HER2 agents was seven times higher than that of patients receiving chemotherapy alone ($864.0 vs. $120.6). Factors affecting the cost per inpatient admission were age, residence (urban or rural), occupation, and health insurance reimbursement rate. Conclusions: HER-positive breast cancer treatment imposes a significant financial burden in Vietnam, particularly with regimens containing HER2-targeted therapies. The findings of our study add to the increasing literature on the cost of breast cancer treatment and can contribute to the pharmacoeconomic analysis of HER2-positive breast cancer treatment in Vietnam.