title: Health care costs for the treatment of breast cancer recurrent events: estimates from a UK-based patient-level analysis.
abstract: Cost pressures and the need to demonstrate cost-effectiveness of new interventions require consideration of the costs of treating disease. This study presents analyses of resource use data covering 199 postmenopausal women who experienced a breast cancer recurrent event between 1991 and 2004 and were treated at the Western General Hospital, Edinburgh. Aggregate (5-year) treatment costs for alternative recurrent events were estimated, as well as the annual costs incurred by patients experiencing contralateral, locoregional, or distant recurrence, who remained alive without further recurrence for a year. The 95% confidence intervals for the 5-year costs of recurrence ranged from pounds 10,000 to pounds 37,000 for locoregional recurrence, and pounds 14,500- pounds 20,000 for distant recurrence. No evidence of significant variations in these costs across time periods between 1991 and 2004 was identified. Annual costs for patients remaining in the same health state showed high initial costs for contralateral and locoregional recurrence, with low costs in subsequent years, while costs associated with distant recurrence declined at a slower rate and plateaued at 4-5 years post-diagnosis. The cost estimates presented in this paper not only inform the magnitude of the resource consequences of breast cancer recurrences, but they are also better suited to informing cost-effectiveness analyses, which have a far greater role in allocating health-care resources.
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield, UK. j.karnon@sheffield.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Karnon
authors.forename: G R
authors.initials: GR
authors.lastname: Kerr
authors.forename: W
authors.initials: W
authors.lastname: Jack
authors.forename: N L
authors.initials: NL
authors.lastname: Papo
authors.forename: D A
authors.initials: DA
authors.lastname: Cameron
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000191:economics* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D016019:Survival Analysis; D013997:Time Factors; D006113:United Kingdom