• Rebecca Tombleson.
• Oncology Analytics, Inc, Atlanta, GA. Email: rtombleson@oncologyanalytics.com.
• Am J Manag Care. 2021 Apr 1; 27 (5 Suppl): S97-S103.

AbstractThe cost of metastatic triple-negative breast cancer (mTNBC) continues to rise; before the use of immune checkpoint inhibitors in mTNBC, cumulative costs of treatment ranged from $51,070 for patients not treated with chemotherapy, up to $143,150 for patients who received three or more regimens. For those with programmed death ligand 1 (PD-L1)-positive mTNBC, expanding treatments continue to be approved for combination first-line therapy. Both combination atezolizumab with nab-paclitaxel and pembrolizumab with chemotherapy have been recently approved for this population under accelerated approval. Managed care pharmacists should continue to emphasize evidence-based treatment that is consistent with National Comprehensive Cancer Network guidelines, as non-concordance has been associated with increased costs and worsened outcomes. There are several tools that can be used to assess the value of treatment, with significant heterogeneity among frameworks. Innovative programs that have the potential to decrease costs should be considered when evaluating payment models.

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