Health System Costs for Stage-Specific Breast Cancer: A Population-Based Approach

Abstract

Objective: The objective of the present analysis was to determine the publicly funded health care costs associated with the care of breast cancer (BCa) patients by disease stage. Methods: Incident cases of female invasive BCa (2005–2009) were extracted from the Ontario Cancer Registry and linked to administrative datasets from the publicly funded system. The type and use of health care services were stratified by disease stage over the first 2 years after diagnosis. Mean costs and costs by type of clinical resource used in the care of BCa patients were compared with costs for a matched control group. The attributable cost for the 2-year time horizon was determined in 2008 Canadian dollars. Results: This cohort study involved 39,655 patients with BCa and 190,520 control subjects. The average age in those groups was 61.1 and 60.9 years respectively. Most BCa patients were classified as either stage I (34.4%) or stage II (31.8%). Of the BCa cohort, 8% died within the first 2 years after diagnosis. The overall mean cost per BCa case from a public payer perspective in the first 2 years after diagnosis was $41,686. Over the 2-year time horizon, the mean cost increased by stage: I, $29,938; II, $46,893; III, $65,369; and IV, $66,627. The attributable cost of BCa was $31,732. Cost drivers were cancer clinic visits, physician billings, and hospitalizations. Conclusions: Costs of care increased by stage of BCa. Cost drivers were cancer clinic visits, physician billings, and hospitalizations. These data will assist planning and decision-making for the use of limited health care resources.

Cost Implications of Unwarranted Imaging for Distant Metastasis in Women with Early-Stage Breast Cancer in Ontario

“…Higher imaging costs in stage ii patients could indicate that patients with increased disease severity had a worse prognosis and might have required more frequent pre-and postoperative assessment and follow-up. Our results are consistent with those of Mittmann et al 11 , who suggested that, compared with patients at other disease stages, patients with stage ii breast cancer consumed the largest overall total health care cost-mainly because they had more frequent cancer clinic visits, more physician claims, and were hospitalizations.…”

Cost Trajectories for Cancer Patients

“…The broad approaches do not assess patient-level costs and belie the notion that costs are highly concentrated within certain groups of patients. Patients with cancer have high costs across the health care system both because of high incremental costs for treatment [11][12][13][14][15] and because of increasing prevalence 16 . Ontario-based research identified cancer treatment as one of the most common causes for hospitalization among the highest-cost health care users a, 17 .…”

Reoperation Costs in Attempted Breast-Conserving Surgery: A Decision Analysis

“…Surgery represents the single most important intervention in the care of patients with nonmetastatic breast cancer, and it is responsible for a significant component of the initial health care cost associated with the treatment of breast cancer 33 . Given the significant variation in the need for reoperation after an initial attempt at bcs, the reoperation rate becomes a potential area of focus in the pursuit of health care cost reductions.…”