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Medical costs of treating breast cancer among younger Medicaid beneficiaries by stage at diagnosis

  • Epidemiology
  • Published:
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Abstract

Background

Younger women (aged 18–44 years) diagnosed with breast cancer often face more aggressive tumors, higher treatment intensity, and lower survival rates than older women. In this study, we estimated incident breast cancer costs by stage at diagnosis and by race for younger women enrolled in Medicaid.

Methods

We analyzed cancer registry data linked to Medicaid claims in North Carolina from 2003 to 2008. We used Surveillance, Epidemiology, and End Results (SEER) Summary 2000 definitions for cancer stage. We split breast cancer patients into two cohorts: a younger and older group aged 18–44 and 45–64 years, respectively. We conducted a many-to-one match between patients with and without breast cancer using age, county, race, and Charlson Comorbidity Index. We calculated mean excess total cost of care between breast cancer and non-breast cancer patients.

Results

At diagnosis, younger women had a higher proportion of regional cancers than older women (49 vs. 42%) and lower proportions of localized cancers (44 vs. 50%) and distant cancers (7 vs. 9%). The excess costs of breast cancer (all stages) for younger and older women at 6 months after diagnosis were $37,114 [95% confidence interval (CI) = $35,769–38,459] and $28,026 (95% CI = $27,223–28,829), respectively. In the 6 months after diagnosis, the estimated excess cost was significantly higher to treat localized and regional cancer among younger women than among older women. There were no statistically significant differences in excess costs of breast cancer by race, but differences in treatment modality were present among younger Medicaid beneficiaries.

Conclusions

Younger breast cancer patients not only had a higher prevalence of late-stage cancer than older women, but also had higher within-stage excess costs.

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Acknowledgements

Work on this study was supported by the Integrated Cancer Information and Surveillance System (ICISS), UNC Lineberger Comprehensive Cancer Center with funding provided by the University Cancer Research Fund (UCRF) via the State of North Carolina.

Funding

This research was supported by contract number 200-2008-27958 Task Order 38 from the Centers for Disease Control and Prevention.

Disclaimer

The findings and conclusions in this paper are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Author information

Authors and Affiliations

  1. University of North Carolina, 1101-B McGavran-Greenberg Bldg., 135 Dauer Dr., CB-7411, Chapel Hill, NC, 27599-7411, USA

    Justin G. Trogdon & Katherine Reeder-Hayes

  2. Centers for Disease Control and Prevention, Atlanta, GA, USA

    Donatus U. Ekwueme & Cheryll C. Thomas

  3. RTI International, Research Triangle Park, NC, USA

    Diana Poehler & Benjamin T. Allaire

Authors
  1. Justin G. Trogdon
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  2. Donatus U. Ekwueme
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  3. Diana Poehler
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  4. Cheryll C. Thomas
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  5. Katherine Reeder-Hayes
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  6. Benjamin T. Allaire
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Corresponding author

Correspondence to Justin G. Trogdon.

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Conflict of interest

Dr. Trogdon declares that he has no conflict of interest. Dr. Ekwueme declares that he has no conflict of interest. Ms. Poehler declares that she has no conflict of interest. Ms. Thomas declares that he has no conflict of interest. Mr. Allaire declares that he has no conflict of interest.

Ethical approval

The study was reviewed by the UNC Institutional Review Board and deemed to not involve human subjects research.

Appendix

Appendix

See Table 5.

Table 5 Twelve-month excess costs for Medicaid beneficiaries with breast cancer, by SEER stage, and age at diagnosis
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Trogdon, J.G., Ekwueme, D.U., Poehler, D. et al. Medical costs of treating breast cancer among younger Medicaid beneficiaries by stage at diagnosis. Breast Cancer Res Treat 166, 207–215 (2017). https://doi.org/10.1007/s10549-017-4386-2

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  • DOI: https://doi.org/10.1007/s10549-017-4386-2

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