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Adverse breast cancer treatment effects: the economic case for making rehabilitative programs standard of care

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Abstract

Purpose

The purpose of this work was to evaluate the patient-borne financial cost of common, adverse breast cancer treatment-associated effects, comparing cost across women with or without these side effects.

Methods

Two hundred eighty-seven Australian women diagnosed with early-stage breast cancer were prospectively followed starting at 6 months post-surgery for 12 months, with three monthly assessments of detailed treatment-related side effects and their direct and indirect patient costs attributable to breast cancer. Bootstrapping statistics were used to analyze cost data, and adjusted logistic regression was used to evaluate the association between costs and adverse events from breast cancer. Costs were inflated and converted from 2002 Australian to 2014 US dollars.

Results

More than 90 % of women experienced at least one adverse effect (i.e., post-surgical issue, reaction to radiotherapy, upper-body symptoms or reduced function, lymphedema, fatigue, or weight gain). On average, women paid $5,636 (95 % confidence interval (CI), $4,694, $6,577) in total costs. Women with any one of the following symptoms (fatigue, reduced upper-body function, upper-body symptoms) or women who report ≥4 adverse treatment-related effects, have 1.5 to nearly 4 times the odds of having higher healthcare costs than women who do not report these complaints (p < 0.05).

Conclusions

Women face substantial economic burden due to a range of treatment-related health problems, which may persist beyond the treatment period. Improving breast cancer care by incorporating prospective surveillance of treatment-related side effects and strategies for prevention and treatment of concerns (e.g., exercise) has real potential for reducing patient-borne costs.

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Acknowledgments

The authors wish to acknowledge the contributions of the women who participated in the Pulling Through Study. We would also like to acknowledge the National Breast Cancer Foundation (NBCF) for funding the Pulling Through Study, and the fellowship funding support provided by NBCF (SH, TD) and Cancer Council Queensland (SH).

Conflict of interest

Authors Schmitz, DiSipio, Gordon, and Hayes declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Kathryn H. Schmitz

  2. Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, Queensland, 4059, Australia

    Tracey DiSipio & Sandra C. Hayes

  3. Griffith Health Institute, Centre for Applied Health Economics, Griffith University, Logan, Queensland, Australia

    Louisa G. Gordon

Authors
  1. Kathryn H. Schmitz
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  2. Tracey DiSipio
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  3. Louisa G. Gordon
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  4. Sandra C. Hayes
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Corresponding author

Correspondence to Tracey DiSipio.

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Schmitz, K.H., DiSipio, T., Gordon, L.G. et al. Adverse breast cancer treatment effects: the economic case for making rehabilitative programs standard of care. Support Care Cancer 23, 1807–1817 (2015). https://doi.org/10.1007/s00520-014-2539-y

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  • DOI: https://doi.org/10.1007/s00520-014-2539-y

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