Abstract

A few studies have examined the costs of breast cancer treatment in a Medicaid population at the state level. However, no study has estimated medical costs for breast cancer treatment at the national level for women aged 19−44 years enrolled in Medicaid.A sample of 5,542 younger women aged 19−44 years enrolled in fee-for-service Medicaid with diagnosis codes for breast cancer in 2007 were compared with 4.3 million women aged 19−44 years enrolled in fee-for-service Medicaid without breast cancer. Nonlinear regression methods estimated prevalent treatment costs for younger women with breast cancer compared with those without breast cancer. Individual medical costs were estimated by race/ethnicity and by type of services. Analyses were conducted in 2013 and all medical treatment costs were adjusted to 2012 U.S. dollars.The estimated monthly direct medical costs for breast cancer treatment among younger women enrolled in Medicaid was $5,711 (95% CI=$5,039, $6,383) per woman. The estimated monthly cost for outpatient services was $4,058 (95% CI=$3,575, $4,541), for inpatient services was $1,003 (95% CI=$708, $1,298), and for prescription drugs was $539 (95% CI=$431, $647). By race/ethnicity, non-Hispanic white women had the highest monthly total medical costs, followed by Hispanic women and non-Hispanic women of other race.Cost estimates demonstrate the substantial medical costs associated with breast cancer treatment for younger Medicaid beneficiaries. As the Medicaid program continues to evolve, the treatment cost estimates could serve as important inputs in decision making regarding planning for treatment of invasive breast cancer in this population.

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