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46 folds (95% CI = 3.06-3.93) after progression. Also, PPPM costs were 1.74 (95%CI = 1.43-2.12) times higher in patients who died within 1 year after progression relative to survived patients. When considering the interaction between progression and death, deceased patients showed higher increased ratio of PPPM costs after progression (4.91; =value.0001) than survived patients (2.95; 95% CI = 2.61-3.34). From the payer's perspective, more healthcare costs incurred during the progression state than terminal state in HR+, HER2- ABC pat