Healthcare costs associated with breast cancer in Germany: a claims data analysis

Kreis, Kristine; Plöthner, Marika; Schmidt, Torben; Seufert, Richard; Schreeb, Katharina; Jahndel, Veronika; Maas, Sylke; Kuhlmann, Alexander; Zeidler, Jan; Schramm, Anja

doi:10.1007/s10198-019-01148-w

Cited by 16 publications

(26 citation statements)

References 26 publications

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“…Breast cancer is the most frequent cancer in women and in 2018 was the leading cause of cancer-related death in women worldwide [1]. In Germany, breast cancer is the third leading cause of cancer-related deaths and poses a relevant economic burden on the healthcare system [2]. As a result, there is burgeoning interest in researching modifiable factors that causally impact the treatment outcome and prognosis of breast cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Impact of a ketogenic diet intervention during radiotherapy on body composition: III—final results of the KETOCOMP study for breast cancer patients

et al. 2020

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Background: Obesity and low muscle mass are associated with worse outcomes of breast cancer patients. We conducted a controlled trial to study the impact of a ketogenic diet (KD) based on natural foods versus an unspecified standard diet (SD) on body composition in breast cancer patients undergoing radiotherapy. Methods: Patients with non-metastasized breast cancer were allocated to either the KD (N = 32) or the SD (N = 31) during radiotherapy. Body composition was measured weekly by bioimpedance analysis. Blood parameters and quality of life were assessed before, during, and at the end of radiotherapy. Results: A total of 29 KD and 30 SD patients completed the study. During radiotherapy, mean and median fasting BHB concentrations in the KD group were 0.72 and 0.49 mmol/l (range 0.06-4.9) which was significantly higher than those in the SD group (p < 2.2 × 10 −16). There was a very small and insignificant increase in body weight and fat mass in the SD group, as well as a decrease of fat free mass. In contrast, patients in the KD group lost body weight and fat free and skeletal muscle mass quickly after diet onset, which for the most part was related to water losses. The KD did not cause further substantial changes in fat free or skeletal muscle mass, but was associated with a gradual decrease of 0.4 kg body weight and fat mass per week (p < 0.0001). The KD significantly decreased free T3 levels by 0.06 pg/ml/week (p = 6.3 × 10 −5). Global quality of life remained stable in the SD group but increased in the KD group from a score of 66.7 to 75.0 (p = 0.20). Conclusions: In breast cancer patients undergoing curative radiotherapy, a KD based on natural foods is feasible. After initial water losses, the KD tends to reduce body weight and fat mass while preserving fat free and skeletal muscle mass. Trial registration: ClinicalTrials.gov identifier: NCT02516501, registered on August 06, 2015.

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Section: Introductionmentioning

confidence: 99%

Impact of a ketogenic diet intervention during radiotherapy on body composition: III—final results of the KETOCOMP study for breast cancer patients

et al. 2020

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“…Additionally, the analysis includes non-medical costs in terms of travel expenses. Recent estimations by Kreis et al (41) on travel costs bore by BC patients were extracted; these are based on data from the insurance company AOK.…”

Section: Unit Costs and Non-medical Costsmentioning

confidence: 99%

“…The lack of empirical evidence on stage-wise cost in Germany makes it almost unfeasible to validate the model results using external data. However, for the German BC patients, the current literature elucidates only costs per incident case for the initial phase of care (first 11 months), terminal phase of care (last 11 months of life), and the intermediate phase (any period of that is not classified in the initial or the terminal phases) (41) . Therefore, for the model validation, we used the estimation by phases (i.e., initial, intermediate, and terminal phases) reported by Kreis et al (41) , and we adjusted the estimates for inflation to the year 2021.…”

Section: Validationmentioning

confidence: 99%

“…In order to compare the model outputs and the estimates provided by Kreis et al (41), we assigned costs to BC patients according to the disease management phases: (1) all simulated women in the model that do not die of BC were considered for the initial phase of care. This phase comprises all components except hormonal therapy (extended for two to five years) and surveillance; (2) the intermediate phase comprises the surveillance and hormone therapy cost; and (3) the terminal phase consists of all the women that die of BC.…”

Section: Validationmentioning

confidence: 99%

“…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.…”

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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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Krankheitslast von Brustkrebs in Deutschland: Epidemiologie und Kosten

Hernández

Khan

Schlander

2023

Forum

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Healthcare costs associated with breast cancer in Germany: a claims data analysis

Cited by 16 publications

References 26 publications

Impact of a ketogenic diet intervention during radiotherapy on body composition: III—final results of the KETOCOMP study for breast cancer patients

Impact of a ketogenic diet intervention during radiotherapy on body composition: III—final results of the KETOCOMP study for breast cancer patients

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

Krankheitslast von Brustkrebs in Deutschland: Epidemiologie und Kosten

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