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Published in: Breast Cancer Research and Treatment 2/2017

01-07-2017 | Epidemiology

Breast cancer treatment costs in younger, privately insured women

Authors: Benjamin T. Allaire, Donatus U. Ekwueme, Diana Poehler, Cheryll C. Thomas, Gery P. Guy Jr., Sujha Subramanian, Justin G. Trogdon

Published in: Breast Cancer Research and Treatment | Issue 2/2017

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Abstract

Purpose

Younger women (under age 45 years) diagnosed with breast cancer often face more aggressive tumors, higher treatment intensity, lower survival rates, and greater financial hardship. The purpose of this study was to estimate breast cancer costs by stage at diagnosis during the first 18 months of treatment for privately insured younger women.

Methods

We analyzed North Carolina cancer registry data linked to claims data from private insurers from 2003 to 2010. Breast cancer patients were split into two cohorts: a younger and older group aged 21–44 and 45–64 years, respectively. We conducted a cohort study and matched women with and without breast cancer using age, ZIP, and Charlson Comorbidity Index. We calculated mean excess costs between breast cancer and non-breast cancer patients at 6, 12, and 18 months.

Results

For younger women, AJCC 6th edition stage II cancer was the most common at diagnosis (40%), followed by stage I (34%). On the other hand, older women had more stage I (46%) cancer followed by stage II (34%). The excess costs for younger and older women at 12 months were $97,486 (95% confidence interval [CI] $93,631–101,341) and $75,737 (95% CI $73,962–77,512), respectively. Younger breast cancer patients had both a higher prevalence of later-stage disease and higher within-stage costs.

Conclusions

The study reports high costs of treatment for both younger and older women than a non-cancer comparison group; however, the estimated excess cost was significantly higher for younger women. The financial implications of breast cancer treatment costs for younger women need to be explored in future studies.
Literature
2.
go back to reference Chollet-Hinton L, Anders CK, Tse C-K, Bell MB, Yang YC, Carey LA, Olshan AF, Troester MA (2016) Breast cancer biologic and etiologic heterogeneity by young age and menopausal status in the Carolina Breast Cancer Study: a case-control study. Breast Cancer Res 18(1):79CrossRefPubMedPubMedCentral Chollet-Hinton L, Anders CK, Tse C-K, Bell MB, Yang YC, Carey LA, Olshan AF, Troester MA (2016) Breast cancer biologic and etiologic heterogeneity by young age and menopausal status in the Carolina Breast Cancer Study: a case-control study. Breast Cancer Res 18(1):79CrossRefPubMedPubMedCentral
6.
go back to reference Ekwueme DU, Trogdon JG (2016) The economics of breast cancer in younger women in the US. Am J Prev Med 50(2):249–254CrossRefPubMed Ekwueme DU, Trogdon JG (2016) The economics of breast cancer in younger women in the US. Am J Prev Med 50(2):249–254CrossRefPubMed
7.
go back to reference Maggard MA, O’Connell JB, Lane KE, Liu JH, Etzioni DA, Ko CY (2003) Do young breast cancer patients have worse outcomes? J Surg Res 113(1):109–113CrossRefPubMed Maggard MA, O’Connell JB, Lane KE, Liu JH, Etzioni DA, Ko CY (2003) Do young breast cancer patients have worse outcomes? J Surg Res 113(1):109–113CrossRefPubMed
9.
go back to reference Howard-Anderson J, Ganz PA, Bower JE, Stanton AL (2012) Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: a systematic review. J Natl Cancer Inst 104(5):386–405. doi:10.1093/jnci/djr541 CrossRefPubMed Howard-Anderson J, Ganz PA, Bower JE, Stanton AL (2012) Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: a systematic review. J Natl Cancer Inst 104(5):386–405. doi:10.​1093/​jnci/​djr541 CrossRefPubMed
11.
go back to reference Allaire BT, Ekwueme DU, Guy GP, Li C, Tangka FK, Trivers KF, Sabatino SA, Rodriguez JL, Trogdon JG (2016) Medical care costs of breast cancer in privately insured women aged 18–44 years. Am J Prev Med 50(2):270–277CrossRefPubMed Allaire BT, Ekwueme DU, Guy GP, Li C, Tangka FK, Trivers KF, Sabatino SA, Rodriguez JL, Trogdon JG (2016) Medical care costs of breast cancer in privately insured women aged 18–44 years. Am J Prev Med 50(2):270–277CrossRefPubMed
12.
go back to reference Banegas MP, Guy GP Jr, de Moor JS, Ekwueme DU, Virgo KS, Kent EE, Nutt S, Zheng Z, Rechis R, Yabroff KR (2016) For working-age cancer survivors, medical debt and bankruptcy create financial hardships. Health Aff (Millwood) 35(1):54–61. doi:10.1377/hlthaff.2015.0830 CrossRef Banegas MP, Guy GP Jr, de Moor JS, Ekwueme DU, Virgo KS, Kent EE, Nutt S, Zheng Z, Rechis R, Yabroff KR (2016) For working-age cancer survivors, medical debt and bankruptcy create financial hardships. Health Aff (Millwood) 35(1):54–61. doi:10.​1377/​hlthaff.​2015.​0830 CrossRef
15.
go back to reference Ekwueme DU, Trogdon JG, Khavjou OA, Guy GP (2016) Productivity costs associated with breast cancer among survivors aged 18–44 years. Am J Prev Med 50(2):286–294CrossRefPubMed Ekwueme DU, Trogdon JG, Khavjou OA, Guy GP (2016) Productivity costs associated with breast cancer among survivors aged 18–44 years. Am J Prev Med 50(2):286–294CrossRefPubMed
19.
go back to reference Blumen H, Fitch K, Polkus V (2016) Comparison of treatment costs for breast cancer, by tumor stage and type of service. Am Health Drug Benefits 9(1):23PubMedPubMedCentral Blumen H, Fitch K, Polkus V (2016) Comparison of treatment costs for breast cancer, by tumor stage and type of service. Am Health Drug Benefits 9(1):23PubMedPubMedCentral
23.
go back to reference Charlson M, Szatrowski TP, Peterson J, Gold J (1994) Validation of a combined comorbidity index. J Clin Epidemiol 47(11):1245–1251CrossRefPubMed Charlson M, Szatrowski TP, Peterson J, Gold J (1994) Validation of a combined comorbidity index. J Clin Epidemiol 47(11):1245–1251CrossRefPubMed
24.
go back to reference Warren JL, Yabroff KR, Meekins A, Topor M, Lamont EB, Brown ML (2008) Evaluation of trends in the cost of initial cancer treatment. J Natl Cancer Inst 100(12):888–897CrossRefPubMedPubMedCentral Warren JL, Yabroff KR, Meekins A, Topor M, Lamont EB, Brown ML (2008) Evaluation of trends in the cost of initial cancer treatment. J Natl Cancer Inst 100(12):888–897CrossRefPubMedPubMedCentral
25.
go back to reference Iacus SM, King G, Porro G (2009) CEM: software for coarsened exact matching. J Stat Softw 30:1–27CrossRef Iacus SM, King G, Porro G (2009) CEM: software for coarsened exact matching. J Stat Softw 30:1–27CrossRef
26.
go back to reference American Joint Committee on Cancer (2009) Breast cancer staging, 7th edn American Joint Committee on Cancer (2009) Breast cancer staging, 7th edn
28.
go back to reference Mariotto AB, Yabroff KR, Shao Y, Feuer EJ, Brown ML (2011) Projections of the cost of cancer care in the United States: 2010–2020. J Natl Cancer Inst. 103:117–128CrossRefPubMedPubMedCentral Mariotto AB, Yabroff KR, Shao Y, Feuer EJ, Brown ML (2011) Projections of the cost of cancer care in the United States: 2010–2020. J Natl Cancer Inst. 103:117–128CrossRefPubMedPubMedCentral
29.
go back to reference Christinat A, Di Lascio S, Pagani O (2013) Hormonal therapies in young breast cancer patients: when, what and for how long? J Thorac Dis 5(1):S36–S46PubMedPubMedCentral Christinat A, Di Lascio S, Pagani O (2013) Hormonal therapies in young breast cancer patients: when, what and for how long? J Thorac Dis 5(1):S36–S46PubMedPubMedCentral
30.
go back to reference Aebi S, Davidson T, Gruber G, Cardoso F, Group EGW (2011) Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Anna oncol 22(suppl 6):12–24 Aebi S, Davidson T, Gruber G, Cardoso F, Group EGW (2011) Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Anna oncol 22(suppl 6):12–24
32.
go back to reference Ribnikar D, Ribeiro J, Pinto D, Sousa B, Pinto A, Gomes E, Moser E, Cardoso M, Cardoso F (2015) Breast cancer under age 40: a different approach. Curr Treat Options Oncol 16(4):1–24CrossRef Ribnikar D, Ribeiro J, Pinto D, Sousa B, Pinto A, Gomes E, Moser E, Cardoso M, Cardoso F (2015) Breast cancer under age 40: a different approach. Curr Treat Options Oncol 16(4):1–24CrossRef
33.
34.
37.
go back to reference Korde LA, Partridge AH, Esser M, Lewis S, Simha J, Johnson RH (2015) Breast Cancer in Young Women: Research Priorities. A report of the young survival coalition research think tank meeting. J Adolesc Young Adult Oncol 4(1):34–43CrossRefPubMed Korde LA, Partridge AH, Esser M, Lewis S, Simha J, Johnson RH (2015) Breast Cancer in Young Women: Research Priorities. A report of the young survival coalition research think tank meeting. J Adolesc Young Adult Oncol 4(1):34–43CrossRefPubMed
38.
go back to reference Yabroff KR, Dowling EC, Guy GP Jr, Banegas MP, Davidoff A, Han X, Virgo KS, McNeel TS, Chawla N, Blanch-Hartigan D, Kent EE, Li C, Rodriguez JL, de Moor JS, Zheng Z, Jemal A, Ekwueme DU (2016) Financial hardship associated with cancer in the United States: findings From a population-based sample of adult cancer survivors. J Clin Oncol 34(3):259–267. doi:10.1200/jco.2015.62.0468 CrossRefPubMed Yabroff KR, Dowling EC, Guy GP Jr, Banegas MP, Davidoff A, Han X, Virgo KS, McNeel TS, Chawla N, Blanch-Hartigan D, Kent EE, Li C, Rodriguez JL, de Moor JS, Zheng Z, Jemal A, Ekwueme DU (2016) Financial hardship associated with cancer in the United States: findings From a population-based sample of adult cancer survivors. J Clin Oncol 34(3):259–267. doi:10.​1200/​jco.​2015.​62.​0468 CrossRefPubMed
39.
go back to reference Farooqi B, Smith B, Chowdhary M, Pavoni S, Modi A, Schnell F (2015) Racial disparities in breast cancer diagnosis in Central Georgia in the United States. J Commun Support Oncol 13(12):436–441. doi:10.12788/jcso.0179 CrossRef Farooqi B, Smith B, Chowdhary M, Pavoni S, Modi A, Schnell F (2015) Racial disparities in breast cancer diagnosis in Central Georgia in the United States. J Commun Support Oncol 13(12):436–441. doi:10.​12788/​jcso.​0179 CrossRef
Metadata
Title
Breast cancer treatment costs in younger, privately insured women
Authors
Benjamin T. Allaire
Donatus U. Ekwueme
Diana Poehler
Cheryll C. Thomas
Gery P. Guy Jr.
Sujha Subramanian
Justin G. Trogdon
Publication date
01-07-2017
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 2/2017
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-017-4249-x

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