Cancro de Mama: Valor em Saúde, Custos e Financiamento

Harfouche, Ana; Silva, Sílvia; Faria, João Leal de; Araújo, Rui Maria de; Gouveia, António; Lacerda, Maria Ribeiro; D'Orey, Luís

doi:10.20344/amp.9093

Cited by 7 publications

(7 citation statements)

References 1 publication

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“…The present study compared the BC treatment cost estimates from different European countries (15,17,47). Our estimates are in line with the Belgium study (47) conducted in 2015 assessing direct medical costs.…”

Section: Discussionsupporting

confidence: 77%

“…However, the data in this study (47) was limited to one hospital and to 107 patients (only two patients in stage IV). On the contrary, we observed a mean stage-wise cost difference in our estimations, when compared to an Italian (15) and to a Portuguese study (17,48). This could be mainly because these studies did not specifically included end of life care, and have a shorter follow-up period that potentially underestimates the cost of end of life care.…”

Section: Discussioncontrasting

confidence: 74%

“…The model costs for the intermediate phase are not consistent with the German estimates. We also compared the results of the published German and European literature that mentioned the cost of early and metastatic BC (4,15,17,40,(46)(47)(48) (Table 2 & Table 3) and our estimates are consistent.…”

Section: Validationmentioning

confidence: 54%

“…Therefore, cost-effectiveness analysis of screening programs requires stage-wise costs as inputs. Given that healthcare costs vary considerably among countries (14)(15)(16)(17), it is necessary to establish a basis for the stage-wise costs of BC in the German context.…”

Section: Introductionmentioning

confidence: 99%

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Estimation of the Stage-Wise Costs of Breast Cancer in Germany Using a Modeling Approach

Alam¹,

Hernández-Villafuerte²,

Carreno³

et al. 2022

Preprint

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Breast cancer (BC) is a heterogeneous disease representing a substantial economic burden. In order to develop policies that successfully decrease this burden, the factors affecting costs need to be fully understood. Evidence suggests that early detection in Stage I has a lower cost than late detection. We aim to provide conservative estimates of BC's stage-wise medical costs from German healthcare and the payer's perspective. To this end, we conducted a literature review of articles evaluating stage-wise costs of BC in Germany through PubMed, Web of Science, and Econ Lit databases supplemented by Google Scholar. We developed a decision tree model to estimate BC related medical costs in Germany using available treatment and cost information. The review generated seven studies; none estimated the stage-wise costs of BC. The studies were classified into two groups: (1) case scenarios (five studies) and two studies based on administrative data. The first sickness funds data study (Gruber, Stock, et al. 2012) used 1999 information to approach BC attributable cost; their results suggest a range between €3,929 and €11,787 depending on age. The second study (Kreis, Plöthner, et al. 2020) used 2011-2014 data and suggested an initial phase incremental cost of €21,499, an intermediate phase cost of €2,620, and a terminal phase cost of €34,513 per incident case. Our decision tree model based BC stage-wise cost estimates were €21,523 for Stage I, €25,679 for Stage II, €30,156 for Stage III, €42,086 for Stage IV. Alternatively, the modeled cost estimates are €20,284 for the initial phase of care, €851 for the intermediate phase of care, and €34,963 for the terminal phase of care. Our estimates for phases of care are consistent with recent German estimates provided by Kreis and Plöthner et al. Furthermore, the data collected by sickness funds are collected primarily for reimbursement purposes, where the German ICD-10 classification system defines a cancer diagnosis. As a result, claims data lack the clinical information necessary to understand stage-wise BC costs. Our model-based estimates fill the gap and inform future economic evaluations of BC interventions.

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Section: Discussionsupporting

confidence: 77%

Section: Discussioncontrasting

confidence: 74%

Section: Validationmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Estimation of the Stage-Wise Costs of Breast Cancer in Germany Using a Modeling Approach

Alam¹,

Hernández-Villafuerte²,

Carreno³

et al. 2022

Preprint

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“…Only one study dealt with missing data by multiple imputation [ 20 ]. Nine studies conducted complete-case analysis [ 16 , 17 , 19 , 23 , 26 – 29 , 34 ] and another made assumptions about the incomplete information [ 24 ]. In the remaining studies, there was no mention to the issue of missing data.…”

Section: Resultsmentioning

confidence: 99%

Global treatment costs of breast cancer by stage: A systematic review

et al. 2018

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BackgroundPublished evidence on treatment costs of breast cancer varies widely in methodology and a global systematic review is lacking.ObjectivesThis study aimed to conduct a systematic review to compare treatment costs of breast cancer by stage at diagnosis across countries at different levels of socio-economic development, and to identify key methodological differences in costing approaches.Data sourcesMEDLINE, EMBASE, and NHS Economic Evaluation Database (NHS EED) before April 2018.Eligibility criteriaStudies were eligible if they reported treatment costs of breast cancer by stage at diagnosis using patient level data, in any language.Study appraisal and synthesis methodsStudy characteristics and treatment costs by stage were summarised. Study quality was assessed using the Drummond Checklist, and detailed methodological differences were further compared.ResultsTwenty studies were included, 15 from high-income countries and five from low- and middle-income countries. Eleven studies used the FIGO staging system, and the mean treatment costs of breast cancer at Stage II, III and IV were 32%, 95%, and 109% higher than Stage I. Five studies categorised stage as in situ, local, regional and distant. The mean treatment costs of regional and distant breast cancer were 41% and 165% higher than local breast cancer. Overall, the quality of studies ranged from 50% (lowest quality) to 84% (highest). Most studies used regression frameworks but the choice of regression model was rarely justified. Few studies described key methodological issues including skewness, zero values, censored data, missing data, and the inclusion of control groups to estimate disease-attributable costs.ConclusionsTreatment costs of breast cancer generally increased with the advancement of the disease stage at diagnosis. Methodological issues should be better handled and properly described in future costing studies.

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