The economic burden of advanced breast cancer

Abstract

Background Breast cancer is the most frequently diagnosed and leading cause of death amongst cancers in women. Understanding its burden is important in healthcare management. We assessed direct medical and indirect costs of advanced breast cancer (ABC) in selected countries: Bulgaria, Croatia, Czech Republic, Estonia, Greece, Israel, Latvia, Poland, Romania, and Slovak Republic. Methods The data were collected in individual countries with a unified questionnaire (covering epidemiology, mortality, treatment patterns, and economic aspects) based on databases/registries, published studies, or experts’ opinions in the absence of published data. International scope allowed for consistency checks and missing data imputing. Results The total annual costs of ABC per 100,000 women varied from 1 million EUR in Romania to 3.4 million EUR in Slovak Republic with the differences partially related to data availability. The direct costs resulted mainly from the costs of treatment (covering surgery, breast reconstruction, external breast prosthesis, chemotherapy, radiation, hormonal and targeted therapy). The indirect costs (lost productivity due to premature mortality and reduced employment rate) constitute a large part (>50%) of the total costs. The average (for all countries) total annual costs per 100,000 women amounts to 1.8 million EUR. Conclusion ABC is associated with substantial healthcare costs and imposes a significant societal burden, as indicated by high indirect costs. Early detection, timely intervention, and effective treatment of early stage BC hold potential to decrease burden of ABC. Our findings may be used in informing decisions on resource allocation, improving cancer policies and supporting national cancer plans. Highlights · Advanced breast cancer costs between 1 and 3.4 million euro per 100,000 women in studied countries; lost productivity (from societal perspective) accounts for most of the cost. · The data availability is still limited; comparisons between countries reveal some gaps, but collecting more information, e.g. in registries, is crucial for improved decision making. · The results of our study may be used in cost-effectiveness modelling of diagnostic or treatment technologies.