Breast Cancer Research and Treatment

, Volume 74, Issue 2, pp 143–153 | Cite as

Using Cost-Effectiveness Analysis to Define a Breast Cancer Benefits Package for the Uninsured

  • Jennifer L. Malin
  • Emmett Keeler
  • Cynthia Wang
  • Robert Brook


Objectives. In 1999, California was considering legislation to fund breast cancer treatment for its uninsured. We sought to define the most cost-effective breast cancer benefits package in order to inform this debate.

Methods. We use cost-effectiveness analysis to calculate the additional costs and benefits of various adjuvant therapy strategies, radiation after breast conserving surgery, and reconstruction compared to those of surgery alone in order to define the most cost-effective breast cancer benefits package for uninsured women.

Results. Using cost-effectiveness analysis, we define a Minimum Breast Cancer Benefits Package that includes only the most cost-effective life-saving breast cancer treatments. To provide these benefits for an estimated 550 breast cancer patients will cost $10,200,000. We present two options that each cost an additional $1,700,000 – to expand the benefits to these patients to include post-mastectomy radiation and breast reconstruction; or to provide the Minimum Package to an additional 93 uninsured women.

Conclusions. California legislators must decide whether to offer comprehensive benefits to a limited number of breast cancer patients or to provide only the most life-saving treatments to a greater number of women.

access to care breast cancer cost-effectiveness analysis health policy insurance rationing uninsured 


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Copyright information

© Kluwer Academic Publishers 2002

Authors and Affiliations

  • Jennifer L. Malin
    • 1
    • 2
  • Emmett Keeler
    • 2
  • Cynthia Wang
    • 2
  • Robert Brook
    • 1
    • 2
  1. 1.Department of MedicineUniversity of CaliforniaLos Angeles
  2. 2.RANDSanta MonicaUSA

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