Retrospective cost analysis of breast cancer patients treated in a Brazilian outpatient cancer center (OCC).

Abstract

e11026 Background: Public health data indicate that the global burden of breast cancer in women, measured by incidence and mortality, is substantial. The associated treatment costs increase steadly above economic growth, leading to substantial financial, equity and access problems. However, the economic impact of management costs in Brazilian clinical practice has not been documented yet. Information about patients' quality of life associated with the introduction of new drugs and procedures is also lacking. Methods: This is a retrospective study of women with breast cancer treated at a private practice OCC in Rio de Janeiro, Brazil. All the patients were covered by Amil, a Brazilian HMO. Direct costs (DC) of 199 patients diagnosed since 2002 and followed to the end of 2009 were analyzed and correlated to clinical stage. Results: 48% of women were diagnosed in stage I, 34% patients in stage II, and only 2.5% were diagnosed in stage IV, similar numbers to those seen in developed countries. The average DC of their medical care per patient was US$21,658.94 (mean 2.48 yrs ± SD 1.66) for stage I compared to US$48,295.29 (mean 2.76 yrs ± SD 1.67) for stage II, and were US$63,662.06 (mean 2.34 yrs ± SD 1.56) for stage III and US$63,697.33 (mean 1.77 yrs ± SD 0.80) for stage IV. We also observed that DC per patient-year increased according to clinical stage. In the first year, average cost was US$15,183.85 for stage I, while it was US$ 44,160.74 for stage IV. Those DC decreased along the years in all stages. For example, in the seventh year of follow-up, the average DC was only US$ 467.27 for stage I (2005 purchasing power parity index 1 USD = 1.4 BRL). Conclusions: Breast cancer accounts for a significant part of the health insurance budget. Later stage at diagnosis is associated with higher DC per patient-year of treatment, and known lower probability of 5-year survival. No significant financial relationships to disclose.