Breast Cancer Treatment Costs Research Articles

Factors Affecting Breast Cancer Screening Behavior Among Women in Saudi Arabia: A Retrospective Cross-Sectional Study.

Background Early detection of breast cancer is crucial for effective treatment and minimizing mortality, requiring effective screening methods like self-examination, clinical examination, and mammography. However, not all women in Saudi Arabia comply with these examinations, and studies examining its practice and barriers of low uptake are scant. The aim of this study is to investigate factors influencing breast cancer screening behavior among women in Saudi Arabia. Methods This cross-sectional study involving 806 women from October to November 2022 used an online questionnaire for the data collection process, including questions about demographic characteristics, awareness assessment, breast cancer screening behavior, symptoms, risk factors, and screening programs. Factors affecting the screening behavior were analyzed using the logistic regression model with adjusted odds ratio (AOR) and 95% confidence interval (CI). Results Among the 806 women who participated in the study, 479 (59.4%) were under 40 years old, and half of them were urban residents (n = 394, 48.9%). Only 134 subjects (16.6%) had a history of breast screening. Social media (n = 519, 64.5%) was the predominant source of screening information. The primary obstacles to breast cancer screening were the absence of tumor symptoms (n = 333, 41.3%), insufficient knowledge about early detection (n = 249, 31%), lack of time (n = 245, 30%), fear of discovering a tumor (n = 187, 23%), and lack of awareness about screening centers (n = 155, 19%).In regression analysis, predictive factors for breast cancer screening behavior were as follows: age over 40 years old (AOR: 2.56; 95% CI: 1.70-3.87), residents of big cities (AOR: 3.57; 95% CI: 1.02-12.56), positive family history of breast cancer (AOR: 2.53; 95% CI: 1.50-4.28), proximity to the screening center (AOR: 2.56; 95% CI: 1.22-5.39), and using contraceptive pills for more than five years (AOR: 1.78; 95% CI: 1.04-3.04), and were statistically significant (all p-values < 0.05). Conclusions In this study, the most perceived barriers to BSE were the absence of tumor symptoms, followed by insufficient knowledge about early detection, lack of time, fear of discovering a tumor, and lack of awareness about screening centers. Additionally, the predictive factors for breast cancer screening behavior were as follows: age over 40 years old, residents of big cities, positive family history of breast cancer, proximity to the screening center, and using contraceptive pills for more than five years. Given the identified factors affecting breast self-examination behavior in this study, public education initiatives are crucial for raising awareness, facilitating self-examination, and ultimately improving health outcomes and reducing breast cancer treatment costs in society.

Short-term and long-term financial toxicity from breast cancer treatment: a qualitative study.

The rising cost of breast cancer treatment has increased patients' financial burden, intensifying an already stressful treatment process. Although researchers increasingly recognize the harmful impact of medical and nonmedical costs associated with cancer treatment, understanding patients' perspectives of financial toxicity is limited. We aimed to explore the topic of financial toxicity through the lived experiences of patients with breast cancer from groups at risk of social and economic marginalization. We conducted semi-structured interviews with 50 women with breast cancer from four specific groups: Black women, Medicaid enrollees, rural residents, and women age ≤ 40. We transcribed, coded, and analyzed the data using deductive and inductive approaches. Two overarching themes captured patients' experiences of financial toxicity: short-term and long-term impacts. Short-term stressors included direct medical (e.g., co-pays, premiums), nonmedical (e.g., transportation, lodging), and indirect (e.g., job loss, reduced work hours) costs. Early in their treatments, patients' focus on survival took precedence over financial concerns. However, as the treatment course progressed, fear of consequences from compounding costs of care and financial distress negatively impacted patients' lifestyles and outlooks for the future. Programs addressing financial toxicity that look beyond early-phase interventions are needed. Specifically, patients struggling with the accumulation of treatment costs and the resultant stress require ongoing support. Long-term support is especially needed for groups vulnerable to financial instability and social marginalization.

Medical care costs according to the stage and subtype of breast cancer in a municipal setting: a case study of Hachioji City, Japan

BackgroundIt is important to assess whether the early detection of breast cancer affects medical care costs. However, research remains scant on the actual medical care costs associated with breast cancer treatment in Japan. This study aimed to determine the medical care costs of breast cancer treatment based on its stage using national health insurance claims data.MethodsThis was an observational study including patients with breast cancer who had undergone breast cancer treatment, as defined by the disease name and related treatment codes. Between August 2013 and June 2016, patients who underwent surgical treatment without axillary lymph node dissection and other radical treatment were classified as the curable group, while those who underwent palliative treatment were classified as the non-curable group. Patients were further stratified by subtype. The total and treatment-specific medical care costs for the five years were calculated using the national health insurance claims data of Hachioji City between August 2013 and May 2021.ResultsThe mean total medical care costs for the curable and non-curable groups for the 5 years were JPY 3958 thousand (standard deviation 2664) and JPY 8289 thousand (8482), respectively. The mean medical care costs for specific breast cancer treatment for the curable and non-curable groups were JPY 1142 (728) thousand and JPY 3651 thousand (5337), respectively. Further, human epidermal growth factor receptor 2 + , Hormone + patients had the highest mean cost over the 5 years.ConclusionsThe results suggest that the early detection of breast cancer may reduce medical care costs at the patient level.

Capturing the True Cost of Breast Cancer Treatment: Molecular Subtype and Stage-Specific per-Case Activity-Based Costing.

Breast cancer (BC) treatment is rapidly evolving with new and costly therapeutics. Existing costing models have a limited ability to capture current treatment costs. We used an Activity-Based Costing (ABC) method to determine a per-case cost for BC treatment by stage and molecular subtype. ABC was used to proportionally integrate multidisciplinary evidence-based patient and provider treatment options for BC, yielding a per-case cost for the total duration of treatment by stage and molecular subtype. Diagnostic imaging, pathology, surgery, radiation therapy, systemic therapy, inpatient, emergency, home care and palliative care costs were included. BC treatment costs were higher than noted in previous studies and varied widely by molecular subtype. Cost increased exponentially with the stage of disease. The per-case cost for treatment (2023C$) for DCIS was C$ 14,505, and the mean costs for all subtypes were C$ 39,263, C$ 76,446, C$ 97,668 and C$ 370,398 for stage I, II, III and IV BC, respectively. Stage IV costs were as high as C$ 516,415 per case. When weighted by the proportion of molecular subtype in the population, case costs were C$ 31,749, C$ 66,758, C$ 111,368 and C$ 289,598 for stage I, II, III and IV BC, respectively. The magnitude of cost differential was up to 10.9 times for stage IV compared to stage I, 4.4 times for stage III compared to stage I and 35.6 times for stage IV compared to DCIS. The cost of BC treatment is rapidly escalating with novel therapies and increasing survival, resulting in an exponential increase in treatment costs for later-stage disease. We provide real-time, case-based costing for BC treatment which will allow for the assessment of health system economic impacts and an accurate understanding of the cost-effectiveness of screening.

PO-1092 Cost of breast cancer treatment: a longitudinal cohort study from tertiary cancer center.

PO-1092 Cost of breast cancer treatment: a longitudinal cohort study from tertiary cancer center.

Household treatment cost of breast cancer and cost coping strategies from a tertiary facility in Ghana.

Breast cancer is the number one cause of cancer death in women globally. According to the Global cancer registry, there were 2.3 million new cases of breast cancer diagnosed in 2020 worldwide, accounting for 25% of all cancer cases in women. The data on the cost burden of breast cancer on households is limited in Ghana, it is therefore imperative that it is estimated to ensure effective planning and provision of adequate resources for breast cancer treatment. This cost-of-illness study estimates the household treatment cost of breast cancer and the cost coping strategies used by patients. This cost-of-illness study was conducted at the surgical unit (Surgical unit 2) of the Korle Bu Teaching Hospital (KBTH), with 74 randomly selected patients and their accompanying caregiver(s). Data was collected using structured questionnaire on direct, indirect and intangible costs incurred and coping strategies used by patients and their households. The results are presented in descriptive and analytic cost statistics. Most of the patients were aged 40-69 years and were married with moderate education levels. Nearly 57% of patients earn an income of USD 370 or less per month. The average household expenditure was USD 990.40 (medical cost: USD 789.78; non-medical cost: USD 150.73; and indirect cost: USD 50). The publicly provided mechanism was the most utilized cost coping strategy. The direct, indirect and intangible costs associated with breast cancer treatment had significant financial and psychological implications on patients and their households. Moreover, poorer families are more likely to use the publicly provided strategies to cope with the increasing cost of breast cancer treatment.

Costs of breast cancer treatment incurred by women in Vietnam

BackgroundThere is a paucity of research on the cost of breast cancer (BC) treatment from the patient’s perspective in Vietnam.MethodsIndividual-level data about out-of-pocket (OOP) expenditures on use of services were collected from women treated for BC (n = 202) using an online survey and a face-to-face interview at two tertiary hospitals in 2019. Total expenditures on diagnosis and initial BC treatment were presented in terms of the mean, standard deviation, and range for each type of service use. A generalised linear model (GLM) was used to assess the relationship between total cost and socio-demographic characteristics.Results19.3% of respondents had stage 0/I BC, 68.8% had stage II, 9.4% had stage III, none had stage IV. The most expensive OOP elements were targeted therapy with mean cost equal to 649.5 million VND ($28,025) and chemotherapy at 36.5 million VND ($1575). Mean total OOP cost related to diagnosis and initial BC treatment (excluding targeted therapy cost) was 61.8 million VND ($2667). The mean OOP costs among patients with stage II and III BC were, respectively, 66 and 148% higher than stage 0/I.ConclusionsBC patients in Vietnam incur significant OOP costs. The cost of BC treatment was driven by the use of therapies and presentation stage at diagnosis. It is likely that OOP costs of BC patients would be reduced by earlier detection through raised awareness and screening programmes and by providing a higher insurance reimbursement rate for targeted therapy.

Direct medical costs of breast cancer treatment at the Joliot Curie Institute of the Aristide Le Dantec Hospital in Dakar, Senegal

in 2020, the incidence of breast cancer was 2261419 cases worldwide, 1186598 cases in Africa and 817 cases in Senegal. However, direct medical costs of cancer treatment are not known in Senegal. For a better resource allocation, it is important to estimate costs. The purpose of this study is to analyze direct medical costs of breast cancer treatment at the Joliot Curie Institute in Dakar. we conducted a retrospective study of patients diagnosed with breast cancer between January and December 2017 at the Joliot Curie Institute. A questionnaire survey and semi-structured interviews were conducted among patients and their relatives to reconstruct direct medical costs. average direct medical costs of breast cancer treatment at the Joliot Curie Institute were $33 713.45 with a minimum of $1 495.15 and a maximum of $10 662.97 over an average period of 31 months. These costs include chemotherapy (29%); diagnosis (15%) and surgery (15%). Costs of radiotherapy and prescription medicines accounted for 13% for each procedure. Medical costs were related to educational level (p=0.05) and stage of disease (p=0.03). direct medical costs of breast cancer treatment are very high in Senegal. Direct medical costs of maximum treatment is $10 662.97 and of minimum treatment is $495.15, reflecting an average cost of $3 713.45.

Health system cost of breast cancer treatment in Addis Ababa, Ethiopia.

Breast cancer is the leading cancer among women with an annual crude incidence of 27.4 per 100,000 in Ethiopia. The aims of this study were to (a) estimate the unit cost of breast cancer treatment for the standard Ethiopian patient, (b) identify the cost drivers, (c) project the total cost of breast cancer treatment for the next five years, and (d) estimate the economic burden of the disease in the main specialized tertiary hospital-Tikur Anbessa Specialized Hospital (TASH) Addis Ababa. Primary data were collected from health and non-health professionals. Secondary data were collected from patient`s charts and official reports from various national and international organisations including data from TASH. To establish work-time estimates, we asked professionals on their time usage. A total of US$ 33,261 was incurred to treat 52 Addis Ababa resident female breast cancer patients in TASH between July 2017 and June 2019. The unit cost of treatment for a hypothetical breast cancer patient to complete her treatment was US$ 536 for stage I and US$ 705 for stage II and III using the existing infrastructure. This cost increased to US$ 955 for stage I and US$ 1157 for stage II and III when infrastructure amortization was considered. The projected total costs of breast cancer treatment in TASH is between US$ 540,000 and US$ 1.48million. However, this will increase to US$ 870,000 and US$ 2.29 million when the existing fixed assets are changed. The economic burden of breast cancer treatment is high compared to the economic status of the country. Thus, it is recommended that TASH should revise its charges and breast cancer should be included in the Social and Community based health insurance scheme. JEL classification: H51, H75, I18, P46.

Clinical Utility of Multigene Assays for Guiding Treatment Decisions in Early Breast Cancer Patients

The clinical management of invasive breast cancer has changed during the last decade with the use of molecular-based multigene assays (MGAs).They are increasingly used to gain additional prognostic and predictive information and guide adjuvant treatment decisions. Since 2004, several MGAs have become available but, four of them are the most widely used in clinical practice: the OncotypeDX® Breast Recurrence Score, the 70-gene signature MammaPrint®, the Prosigna® (PAM50) and the EndoPredict® (EP/EPclin Scores) assay. However, MGAs are not all the same and they do not provide interchangeable information. They differ in terms of the technological platform used for their development, the number and specific genes assessed, and the patient populations in which they were validated. Furthermore, although they are all validated for providing prognostic information, not all of them are supported with data from prospective randomised trials confirming the clinical value of their use in chemotherapy treatment decisions in certain groups of breast cancer patients; in this regard, so far there are published data only for OncotypeDX and MammaPrint, whilst PAM-50 (Prosigna) and EndoPredict assays are currently not supported by entirely prospective randomized trials evaluating their predictive value of chemotherapy benefit. As such, inclusion of these MGAs in major international treatment guidelines differs in indications for their use in clinical practice as prognosticators only or as predictors of chemotherapy benefit as well. Use of MGAs in clinical decision making can lead to de-escalation of chemotherapy recommendations and thus save a large number of patients from unnecessary side effects and decrease the cost of breast cancer treatment to National Health systems. This review provides an overview of the four most widely used MGAs in clinical practice, including basic information on their development and validation, as well as recent data on the information they can provide.

Unbalanced Treatment Costs of Breast Cancer in China: Implications From the Direct Costs of Inpatient and Outpatient Care in Liaoning Province.

The increasing incidence of breast cancer and its financial burden highlights the need for controlling treatment costs. This study aimed to assess the direct costs of inpatient and outpatient care for breast cancer patients in Liaoning Province to provide a policy reference for cost containment. Based on the System of Health Accounts 2011 (SHA 2011), systematic data collection was conducted via multistage stratified cluster random sampling. A total of 1160 health institutions, including 83 hospitals, 16 public health institutions, 120 primary health institutions, and 941 outpatient institutions were enrolled in 2017. A database was established containing 20 035 patient-level medical records from the information system of these institutions. Curative care expenditure (CCE)was calculated, and generalized linear modeling was performed to determine cost-related factors. In 2017, the CCE for breast cancer was approximately CNY 830.19 million (US$122.96 million) in Liaoning province (0.7% of the total health expenditure and 9.9% of cancer-related healthcare costs). Inpatient care costs were estimated to be CNY 617.27 million (US$91.42 million), accounting for 74.4% of the CCE for breast cancer, almost three times as large as outpatient costs (25.6%). The average inpatient and outpatient costs for breast cancer were estimated to be CNY 12 108 (US$1793) and CNY 829 (US$123) per visit. Medication cost was the main cost driver, which comprised 84.0% of the average outpatient cost and 37.2% of the mean inpatient cost. Breast cancer imposes a large economic burden on patients and the social health insurance system. Results show an irrational cost pattern of inpatient and outpatient services, with patients relying excessively on inpatient services for treatment. Promoting outpatient care whenever relevant is conducive to cost containment and rational utilization of resources.

Long-term cost of breast cancer treatment to the United States Medicare Program by stage at diagnosis

Breast cancer treatment includes increasingly complex and expensive treatments. Accordingly, the current estimates of the cost of breast cancer treatment are out of date. The SEER-Medicare Data Link provided 142,837,978 paid Medicare claims from 398,148 female beneficiaries between the ages of 22 and 110 diagnosed with breast cancer between 2007 and 2016. These claims were compared with 153,071,044 claims from 443,952 Medicare beneficiaries without a cancer diagnosis. The total, fully adjudicated, amounts for each claim were summed to determine total treatment cost for each beneficiary. These costs were then aggregated by year after diagnosis and stage at diagnosis. The actuarial survival of beneficiaries with cancer was calculated using the Kaplan-Meier method. Mean costs for the control group were $8,019 per year. The 10-year cost of cancer treatment in Medicare beneficiaries was directly related to stage at diagnosis and ranged from $103,573 for stage 0 cancers to $376,573 for stage 4 cancers. The highest cost occurred during the first 2years after diagnosis, the time of the beneficiary's initial treatment. Following the first 2years, healthcare costs remained elevated for at least 10years after diagnosis. The 10-year treatment cost of female Medicare beneficiaries with breast cancer increases with increasing stage at diagnosis. Any effective screening technology that reduces stage at diagnosis will result in significant treatment cost savings to the Medicare program.

Financial toxicity due to breast cancer treatment in low- and middle-income countries: evidence from Vietnam

BackgroundThis study examined the financial toxicity faced by breast cancer (BC) patients in Vietnam and the factors associated with the risk and degree of that toxicity.MethodsA total of 309 BC patients/survivors completed an online survey (n=209) or a face-to-face interview (n=100) at two tertiary hospitals. Descriptive statistics and χ2 tests were used to identify and analyse the forms and degree of financial toxicity faced by BC patients/survivors. A Cragg hurdle model assessed variation in risk and the degree of financial toxicity due to treatment.Results41% of respondents faced financial toxicity due to BC treatment costs. The mean amount of money that exceeded BC patients/survivors’ ability to pay was 153 million Vietnamese Dong (VND) ($6602) and ranged from 2.42 million VND to 1358 million VND ($104–58,413). A diagnosis at stage II or III of BC was associated with 16.0 and 18.0 million VND (~$690–777) more in the degree of financial toxicity compared with patients who were diagnosed at stage 0/I, respectively. Being retired or married or having full (100%) health insurance was associated with a decrease in the degree of financial toxicity.ConclusionsA significant proportion of Vietnamese BC patients/survivors face serious financial toxicity due to BC treatment costs. There is a need to consider the introduction of measures that would attenuate this hardship and promote uptake of screening for the reduction in financial toxicity as well as the health gains it may achieve through earlier detection of cancer.

Looking for Metastasis in Early Breast Cancer: Does Bone Scan Help? A Retrospective Review

BackgroundRoutine staging investigations are not recommended for early breast cancer (EBC). Staging scans and further confirmatory tests add to the cost of breast cancer treatment. Despite recommendations from international guidelines, whole body bone scan (BS) is commonly used for staging EBC. We examined our experience with BS as a staging investigation when selectively used in EBC. Patients and MethodsAll EBC patients who underwent treatment through the Eastern Health breast unit during a 50-month period from January 2012 were included in this study. All staging BS results were reviewed to evaluate yield and false-positive rate. The causes of false-positive results were analyzed. The role of BS when performed along with computed tomographic scans of chest, abdomen, and pelvis (CTCAP) was evaluated. ResultsEven with the selective use of BS, we could only achieve a yield of 1% (95% confidence interval, −0.6, 2.7) in EBC. When combined with CTCAP, only one additional metastasis was detected in 194 BSs. ConclusionBS plays only a limited role in staging EBC. Patients who have undergone CTCAP will experience minimal benefit by undergoing additional BS.

Development of a method to determine the cost of breast cancer treatment with chemotherapy at Groote Schuur Hospital, Cape Town, South Africa.

There has been no comprehensive study determining the financial burden of breast cancer in the South African (SA) public sector. To develop a method to determine the cost of breast cancer treatment with chemotherapy per episode of care and to quantify the associated costs relating to chemotherapy at Groote Schuur Hospital (GSH), a government hospital in SA. These costs included costs associated with the management of adverse events arising from chemotherapy. Retrospective patient-level data were collected for 200 patients from electronic databases and patient folders between 2013 and 2015. Direct medical costs were determined from the health funder's perspective. The information collected was categorised into the following cost components: chemotherapy medicines, support medicines, administration of chemotherapy, laboratory tests, radiology scans and imaging, doctor consultations and adverse events. Time-and-motion studies were conducted on a set of new patients and the data obtained were used for the study sample of 200 patients. All the above costs were used to determine the cost of chemotherapy per episode of care. The episode of care was defined as the care provided from 2 months prior to the date of commencing chemotherapy (pre-chemotherapy phase), during chemotherapy (treatment phase) and until 6 months after the date when the last cycle of chemotherapy was administered (follow-up phase). A method was developed to determine the episode-of-care costs for breast cancer at GSH. The total direct medical cost for treatment of breast cancer at GSH for 200 patients was ZAR3 154877, and the average episode-of-care cost per patient was ZAR15 774. The average cost of management of adverse events arising from the various treatment modalities was ZAR13 133 per patient. It was found that the cost of treating a patient with adverse events was 1.8 times higher than the cost of treating a patient without adverse events. Of the patients, 86.5% managed to complete their prescribed chemotherapy treatment cycles, and the average cost of treatment of these patients was 1.3 times more than the average cost for patients who could not complete their treatment, based on the number of treatment cycles received. A comprehensive method to determine the costs associated with breast cancer management per episode of care was developed, and costs were quantified at GSH according to the treatment protocol used at the hospital.

The Application of Activity-Based Costing for Public Hospital Sector Sustainability

The research objective is to analyse the cost by the application of Activity-Based Costing of the cancer treatment process at a Thai public hospital by comparing the cost of cancer treatment with the compensation received from the National Health Security Office to set sustainability policy. Historical data were collected from 698, 295 and 348 cases of patients with breast cancer, liver cancer and colorectal cancer, respectively, from 1 October 2017 to 30 September 2018 by creating a matrix of coefficients and constants.The results showed that the cost of breast cancer treatment included the costs of 5 activities: breast cancer surgery, radiation, chemotherapy, the use of anti-hormone drugs and the treatment at the targeted cancer. The costs for the treatment of liver cancer included the costs of 5 activities: liver cancer surgery, TACE, radiation, chemotherapy and the treatment at the targeted cancer.And the cost of the treatment of colorectal cancer included the costs of 3 activities: colon cancer surgery, radiation and the use of chemotherapy.The treatments were found that the cost calculated from the activity-based were higher than the compensation received from the National Health Security Office. The research data constitute useful information for executives involved in policy makingabout managing and resources allocation to be the most appropriate and cost-effectiveness for sustainability of public hospitals in Thailand.

Breast Cancer Population Screening Program Results in Early Detection and Reduced Treatment and Health Care Costs for Medicaid.

The National Breast and Cervical Cancer Early Detection Program has increased access to screening services for low-income females since 1991; however, evaluation information from states implementing the program is sparse. This study evaluates the impact of the Missouri program, Show Me Healthy Women (SMHW), on early detection and treatment cost. To estimate breast cancer treatment and health care services costs by stage at diagnosis among Missouri's Medicaid beneficiaries and assess the SMHW program impact. Analyzed Missouri Medicaid claims linked with Missouri Cancer Registry data for cases diagnosed 2008-2012 (N = 1388) to obtain unadjusted and incremental costs of female breast cancer treatment and follow-up care at 6, 12, and 24 months following diagnosis. Noncancer controls (N = 3840) were matched on age, race, and disability to determine usual health care cost. Regression analyses estimated the impact of stage at diagnosis on expenditures and incremental cost. Show Me Healthy Women participants were compared with other breast cancer patients on stage at diagnosis. A comparison of SMHW participants to themselves had they not been enrolled in the program was analyzed to determine cost savings. Expenditures increased by stage at diagnosis from in situ to distant with unadjusted cost at 24 months ranging from $50 245 for in situ cancers to $152 431 for distant cancers. Incremental costs increased by stage at diagnosis from 6 months at $7346, $11 859, $21 501, and $20 235 for in situ, localized, regional, and distant breast cancers, respectively, to $9728, $17 056, $38 840, and $44 409 at 24 months. A significantly higher proportion of SMHW participants were diagnosed at an early stage resulting in lower unadjusted expenditures and cost savings. Although breast cancer treatment costs increased by stage at diagnosis, the population screening program's significant impact on early diagnosis resulted in important cost savings over time for Medicaid.

Determining Breast Cancer Treatment Costs Using the Top Down Cost Approach.

Breast cancer is the most common type of cancer among women in Turkey, with approximately 15.000 breast cancer diagnoses each year. In this study, our goal was to determine annual direct medical costs of all breast cancer patients in Turkey with top down cost approach. Data regarding patients who have been diagnosed with breast cancer and received health services from any hospital in Turkey in 2014 were used for the purpose of the study. Data were obtained from the MEDULA System for a total of 126.664 patient. Treatment of costs of patients were calculated based on types of patient admissions (inpatient/outpatient/intensive care) and costs of drugs and medical equipment. Indirect costs and out of pocket costs were not included. Total medical costs of 126,664 patients was calculated as $116.792.107,9, with an average treatment cost per patient of $922,1. Based on types of patient admission, intensive care treatment had the highest average cost with $2.916.5. In metastatic breast cancer patients, average annual treatment cost per patient is $2.326,6, which is 2.8 times higher compared to non-metastatic breast cancer patients. In order to ensure effective resource allocation at micro and macro level, healthcare administrators have to learn costs of diseases with high incidence such as breast cancer. Results obtained from studies on disease costs calculated using the top down cost approach provide data on actual health services use and therefore are seen as important tools for healthcare administrators in terms of effective resource allocation.

Forecasting of Breast Cancer and Diabetes Using Ensemble Learning

Machine learning algorithm plays an important role in our life. It is the subset of Artificial intelligence. Recently, everyone tries to use AI or try to invent something related to AI for making life easier. In the medical field, Machine learning is used for the recognition and classification of diseases. It can classify cancer, diabetes or other diseases more accurately from datasets. So, we propose a model which is the combination of Support vector machine and Ad boost. This combine method is known as Ensemble learner. In this paper, we are predicting diabetes and breast cancer. We have used SVM for classification purpose then have applied Ad boost for boosting purposes. The number of a diabetes patient is increasing very rapidly. It causes many other diseases like kidney failure; Eye disorder etc. No medicines are invented to prevent diabetes fully. Breast cancer is increasing very rapidly between women. The cost of breast cancer treatment is very high. More researches are running on diabetes and breast cancer. We proposed our model to predict the diseases more accurately rather than the previous models.

Adjuvant trastuzumab chemotherapy in early breast cancer: meta-analysis of randomised trials and cost-effectiveness analysis.

Trastuzumab has a large financial impact on the average cost of breast cancer treatment. This study reassessed the cost-effectiveness of listing the drug on the subsidised Australian Pharmaceutical Benefits Scheme. Using a continuous-time, discrete-event microsimulation model, we examined the effect of 1-year trastuzumab on the total number of disability-adjusted life-years (DALYs) averted among Australian women with human epidermal growth factor receptor-2 (HER2) positive early breast cancer. Target population was women aged 30&ndash;100 years and newly diagnosed with the disease in 2003. The model adjusted for tumour size and followed the women up until death or age 100 years. Uncertainty was examined in univariate and probabilistic multivariate sensitivity analyses. The incremental cost-effectiveness ratio (ICER) was A$132,537 (95% confidence interval 91,172&ndash;200,485) per DALY averted. Results were sensitive to restriction of trastuzumab to high-risk (large tumour) and/or high-benefit (young) patients. Suitable combinations of tumour size and age restrictions would improve the cost-effectiveness of trastuzumab. Specifically, restricting trastuzumab to women aged 40 years or younger with tumour sizes 40+ mm reduced the ICER to A$35,290 per DALY averted. Trastuzumab for HER2-positive early breast cancer had a high ICER. It is unclear why the Pharmaceutical Benefits Scheme listing does not use restrictions to improve the cost-effectiveness of the drug.