Long-term medical costs of postmenopausal breast cancer therapy.
BACKGROUND
Since the incidence of breast cancer is growing, prevention programs can be expected to have a large economic impact on the health care system. From a health economic point of view, one is interested in the costs saved by disease prevention.


METHODS
To predict 10-year cumulative incidence-based costs of postmenopausal breast cancer, a state transitional model was developed based on published clinical data. The model simulates disease progression and includes nine health states of 1 year: node-negative and node-positive early cancer; local relapse; metastasis, each with its follow-up states; and death. The cost per state was obtained from a chart review in 118 patients with different disease states. Costs were calculated from the health insurance perspective and discounted at 3%.


RESULTS
The cumulative 10 year cost per patient was equal to 31,774 euro [95% confidence interval (CI) 30,536-33,012 euro] of which 30% was hospital costs, 28% systemic treatment, surgery and radiotherapy and 14% testing. Costs were at their highest following diagnosis and before death.


CONCLUSIONS
This incidence-based approach identified the cost of postmenopausal breast cancer over time and may serve as a valid baseline for assessment of new interventions in prevention or early treatment.
Cocquyt
V
V
Department of Medical Oncology, University Hospital, Ghent, Belgium. veronique.cocquyt@rug.ac.be
Moeremans
K
K
Annemans
L
L
Clarys
P
P
Van Belle
S
S
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000191:economics* / Q000628:therapy*; D005260:Female; D005544:Forecasting; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data; D008875:Middle Aged; D008962:Models, Theoretical; D017698:Postmenopause; D012189:Retrospective Studies