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PharmacoEconomics

, Volume 27, Issue 3, pp 199–209 | Cite as

The Costs of Treating Breast Cancer in the US

A Synthesis of Published Evidence
  • Jonathan D. Campbell
  • Scott D. Ramsey
Review Article

Abstract

Published estimates for the treatment costs of breast cancer vary widely in methodology, perspective, patient populations and time horizon. We systematically summarized and analysed the published literature on per-patient costs of breast cancer, and highlight the perspectives, populations studied, time horizons and future directions for cost studies in breast cancer.

This review included 29 US cost-of-illness studies for breast cancer. The estimates of lifetime per-patient costs of breast cancer ranged from $US20 000 to $US100 000. Payer perspectives were popular, while disease stages I and II were emphasized. The costs of initial and terminal therapy were greater than continuing care on a per-unit time basis, but continuing care accounts for the largest share of lifetime cost due to the relatively long survival of breast cancer patients. Costs of different surgeries were relatively similar (breast-conserving surgery vs mastectomy) but, all else equal, significant costs ($US23 000–31 000) were observed for patients who received adjuvant chemotherapy compared with those who did not. Multiple studies confirmed that costs increased with increased stage of disease and costs decreased with increased age of diagnosis. The question remains whether or not lower costs for elderly patients are associated with lower quality of care. The patient, employer and societal perspectives were rarely presented.

Experts in the field have recommended the societal perspective for US-based cost-effectiveness analyses. Most lifetime cost estimates were likely an underestimate for today’s lifetime cost of treating breast cancer because of changes in practice patterns and improved survival. Further societal-based cost studies that differentiate costs by stage, age and treatment time (initial, continuing and terminal), and include the latest practice patterns would be valuable toward informing US-based cost-effectiveness studies for preventive as well as breast cancer treatment interventions.

Keywords

Breast Cancer Societal Perspective Breast Cancer Treatment Direct Medical Cost Lifetime Cost 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

The authors were supported by a grant from Eli Lilly and Company to perform this research. The authors wish to thank Fred Hutchinson colleagues M. Schwede, S. Taylor and S. Jones for their support in performing literature searches, gathering relevant articles and suggesting methods for synthesizing the literature. E. Meadows of Eli Lilly and Company provided suggestions on a draft manuscript. The authors have no conflicts of interest that are directly relevant to the content of this review.

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Copyright information

© Adis Data Information BV 2009

Authors and Affiliations

  1. 1.Fred Hutchinson Cancer Research CenterSeattleUSA
  2. 2.University of WashingtonSeattleUSA

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