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

Tram Nguyen Nguyet Luu; Hang Thu Thi Ngo; Xuan Dung Ho; Quyen Do Thi Phan; Thanh Viet Truong; Hoang Lan Nguyen; Chinh Van Nguyen; Kiet Tuan Huy Pham; Thi Thanh Huong Nguyen

Journal of Pharmacy & Pharmacognosy Research · 2025 · Tập 13(1) · 264-273

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Tóm tắt

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.

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