A new study finds that the costs of breast cancer chemotherapy vary widely, even among treatment regimens with similar efficacy, and that patients bear a substantial out-of-pocket burden. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the study is the first to examine these cost differences, providing clinicians with accessible information to answer patient questions about their treatment options.
To estimate the costs to payers and patients for breast cancer treatment regimens, Sharon Giordano, MD, MPH, of The University of Texas MD Anderson Cancer Center in Houston, and her colleagues assessed information on 14,643 women who were diagnosed with breast cancer between 2008 and 2012 and who received chemotherapy within three months of diagnosis. Total and out-of-pocket costs were calculated using all claims within 18 months of diagnosis and were normalized to 2013 dollars.
Among the major findings:
- Among patients who did and did not receive trastuzumab, which targets the HER2 protein that is over-expressed in certain types of breast cancer cells, the median insurance payments were $160,590 and $82,260,respectively.
- For patients who did not receive trastuzumab, the median out-of-pocket payment was $2724 and 10 percent of patients paid more than $7041.
- For patients treated with trastuzumab, the median out-of-pocket payment was $3381 and 10 percent paid more than $8384.
- Among patients on high deductible health plans, the median out-of-pocket cost was $5158 and 10 percent of patients paid $11,344 or more.
“We found a wide variation in costs between these regimens, which could result in unnecessary costs to both patients and the health care system,” said Dr. Giordano. “We also found that many patients had high out of pocket costs for their care.” The authors noted that the use of an equally effective but less costly treatment regimen versus the most expensive regimen could reduce national costs of breast cancer care by more than $1 billion each year.
Dr. Giordano added that the costs of cancer care have continued to rise and these costs can place a substantial burden on patients and their families. “The Institute of Medicine has recommended that the costs of care be discussed with patients, and we hope that our findings can be used to inform discussions with patients and promote well-informed shared decisions regarding treatment.”
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