Survival in Women with De Novo Metastatic Breast Cancer: A Comparison of Real-World Evidence from a Publicly-Funded Canadian Province and the United States by Insurance Status

Round 1

Reviewer 1 Report

In the paper „Survival in women with de novo metastatic breast cancer: a  comparison of real-world evidence from a publicly-funded  Canadian province and the United States by insurance status“ authors analysed metastatic breast cancer patient outcomes by distinct health care payers and from two countries. This is a well done study, with adequate statistical methods and comprehensive discussion.

Only minor comments. Please, add description of US patients by insurance status and use through the whole paper uniform terminology: Private Insurance=Insured ?(for example line 16 vs. lines 75,76).

Please, rewrite sentences in lines 38, 39 and 102-104 to make it clearer for readers.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

This manuscript is an original article that retrospectively investigate survival outcomes of patients with de novo metastatic breast cancer in Alberta, Canada through comparison to a similar cohort in the US as a whole and by insurance status. The authors showed that no difference in overall survival was noted between AB and US patients. Furthermore, they demonstrated that the US incurred and AB groups had improved survival relative to the Medicaid and Uninsured groups.

This study was conducted well, and the methods are appropriate. The data are presented clearly. This is a well-written paper that presents interesting data.

The results will be of interest to clinicians and researchers in the field.

Author Response

Please see the attachment.

Author Response File: Author Response.docx