Cross-National Comparison of Medical Costs Shared by Payers and Patients: A Study of Postmenopausal Women with Early-Stage Breast Cancer Based on Assumption Case Scenarios and Reimbursement Fees

Abstract

Background: The objectives of this study were to estimate and cross-nationally compare the medical costs shared by payers and patients and the distributions of medical costs by cost category. Material and Methods: We estimated the medical costs covered from definitive diagnosis to completion of treatments of early-stage breast cancer and follow-up, assuming almost identical medical care provided in Japan, the UK, and Germany. The analysis was performed from the payer's perspective. Medical costs were calculated by multiplying the unit costs by the number of units consumed, based on assumption case scenarios. The medical costs incurred by payers or patients were estimated according to the cost-sharing and the cost-bearing systems in each country. Results: The total medical costs in Japan were much lower than those in the UK and Germany, and these differences were mainly caused by the low costs of surgery and radiotherapy in Japan. For the base-case scenario, the co-payment in Japan (€ 3,486) was found to be 6.4-fold higher than that in Germany (€ 548). The payers in the European countries paid 2.9-fold more than those in Japan (€ ∼25,000 vs. € 8,627). Conclusion: Our results will be useful for policy makers in considering how to share medical costs and how to allocate limited resources.

Coste del tratamiento del cáncer de mama por estadío clínico en el País Vasco

“…En coherencia con lo encontrado en la literatura 2,11,12 los dos determinantes principales del coste total del cáncer de mama son el tratamiento inicial de los estadíos I a III y el coste del estadío IV. Entre todos generan la mayor parte del coste del tratamiento del CM.…”

“…La carga económica de la asistencia sanitaria del cáncer de mama (CM) es importante para el sistema sanitario tanto por su alta incidencia, ya que es el tumor maligno más frecuente y la primera causa de muerte por cáncer en la población femenina, como por el coste de sus tratamientos [1][2][3] . La introducción de nuevas terapias tiene que basarse en la medición de su eficiencia y para ello es indispensable disponer del conocimiento detallado del consumo de recursos asociado 4 .…”

“…La introducción de nuevas terapias tiene que basarse en la medición de su eficiencia y para ello es indispensable disponer del conocimiento detallado del consumo de recursos asociado 4 . A diferencia de otros países 2,4,5 , no disponemos de estudios de costes del CM en España que describan la consecuencia económica de la aplicación de las nuevas guías de práctica clínica y los costes unitarios actuales ni que desagreguen el coste por tipo de tratamiento y estadío clínico [1][2][3][4] . La toma de decisiones acerca de los nuevos tratamientos requiere un conocimiento detallado de los costes que generan.…”

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

“…According to the defined inclusion and exclusion criteria, 244 articles were excluded after reviewing the title and abstract and Seven articles were costing studies evaluating BC costs in the German context. Out of the seven, five studies (40,(43)(44)(45)(46) used case scenarios based on German S3 BC treatment guidelines and other sources from the literature, and costs were calculated mainly using predefined national tariffs such as the DRG (diagnosis-related groups) for inpatient care, the EBM (German Uniform Evaluation Standard) for outpatient care and the Rote Liste for drug prices (40,(43)(44)(45)(46). These studies reported a BC cost per patient; however, the estimates cannot be linked to the disease stages.…”