Population-based health care cost estimates related to breast cancer by staging.

Abstract

6108 Background: This study provides population-based estimates of the costs for women with breast cancer (BC) by disease stage from a Canadian perspective using provincial administrative databases. Methods: All Ontario women with a diagnosis of first incident BC from the Ontario Cancer Registry (2005-2009) were matched to non-BC controls (1:5) based on age (same birth year), geography, income quintile, and the expected resource utilization bands (2 years prior to cancer diagnosis) were linked with their unique and encrypted Health Card Number to provincial health claims (Ontario Ministry of Health and Longterm Care and Cancer Care Ontario). Resources for this preliminary analysis included physician, hospitalizations and same day surgeries (SDS). Unit costs, 2009 Canadian dollars, were applied to resources. Non 2009 costs were inflated to 2009. The cost for BC vs. non-BC was calculated for the entire cohort and by stage of disease for BC cases. Results: There were 39,656 BC cases and 198,280 non-BC controls. Cases and controls were equally matched. The mean age (range) was 61.56 (51-72) years. 87.3% lived in urban areas. The total mean cost per person year (BC vs. non-BC) for physicians was $2,986 vs. $1,155; inpatient $2,972 vs. $1,015; SDS $470 vs. $147. Stage information was available for 15,437 (38.9%) BC cases, where 48.2% were stage I; 34.7% stage II; 10.3% stage III, 6.9% stage IV. Physician costs were $2,894 vs. $1,147 (stage I) for BC vs. non-BC; $3,312 vs. $1,133 (stage II); $4,027 vs. $1,036 (stage III); $5,459 vs. $1,092 (stage IV). Inpatient costs were $1,819 vs. $832 (stage I) for BC vs. non-BC; $3,010 vs. $866 (stage II); $4,774 vs. $816 (stage III); $12,123 vs. $1,009 (stage IV). SDS costs were $462 vs. $143 (stage I) for BC vs. non-BC; $468 vs. $129 (stage II); $455 vs. $124 (stage III); $336 vs. $137 (stage IV). Conclusions: This study provides stage-specific cost estimates for BC, where costs were 2-12 fold higher than those for non-BC and increased by stage for physician and inpatient resources. Further work will focus on costing other resources including medications, home care and radiation.