title: The out of pocket cost of breast cancer survivors: a review.
abstract: BACKGROUND
  Out of pocket (OOP) costs add to the burden facing breast cancer survivors but remain an understudied area of costs. Current turbulent economic climate increases the urgency to better understand this burden. Few studies or systematic reviews focus on OOP costs.
  
  
  METHODS
  PubMed search was conducted for articles in English containing: (1) MESH terms breast neoplasms and economics, and (2) words "breast cancer" and "cost" or "costs," "expenditure," or "out of pocket." Limits included: publication dates from January 1, 1980 to December 16, 2009, and populations aged > or = 45 years old. Articles were excluded based on title, abstract, and full text reviews. Citation searches and searches of reference lists were also conducted. Three articles were selected for this review.
  
  
  RESULTS
  Medical direct OOP costs (e.g., for physician fees) ranged from $300 to $1,180 per month during active treatment, and were about $500 per month 1 year post diagnosis. Non-medical direct OOP costs (e.g., for transportation to doctor's office, parking etc.) ranged from $137 to $174 per month in the year post diagnosis; and $200-$509 per month 1 year or more after diagnosis. Different types of costs were identified.
  
  
  CONCLUSIONS
  OOP costs represent a significant burden for survivors even after initial treatment. The nature and extent of OOP costs need further evaluation.
  
  
  CONCLUSIONS
  OOP costs are rarely considered. However, as OOP costs affect the well being of cancer survivors, they should be understood more fully and possibly addressed in interventions aimed at improving quality of life.
authors.affiliation: University of Alabama at Birmingham, USA. mpisu@uab.edu
authors.forename: Maria
authors.initials: M
authors.lastname: Pisu
authors.forename: Andres
authors.initials: A
authors.lastname: Azuero
authors.forename: Patrick
authors.initials: P
authors.lastname: McNees
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Burkhardt
authors.forename: Rachel
authors.initials: R
authors.lastname: Benz
authors.forename: Karen
authors.initials: K
authors.lastname: Meneses
mesh_terms: D001943:Breast Neoplasms / Q000191:economics*; D017281:Cost of Illness; D005260:Female; D006801:Humans; D017741:Survivors
references.citation: Pharmacoeconomics. 2009;27(3):199-209
references.pmid: 19354340
references.citation: Cancer Invest. 2007 Feb;25(1):47-54
references.pmid: 17364557
references.citation: Cancer Nurs. 1999 Oct;22(5):389-96
references.pmid: 10526432
references.citation: J Health Econ. 2002 Sep;21(5):757-79
references.pmid: 12349881
references.citation: Psychooncology. 2007 Dec;16(12):1130-9
references.pmid: 17345557
references.citation: Cancer Pract. 1998 May-Jun;6(3):182-7
references.pmid: 9652250
references.citation: Eur J Cancer Care (Engl). 2007 Nov;16(6):500-7
references.pmid: 17944764
references.citation: J Health Care Poor Underserved. 2009 Aug;20(3):721-8
references.pmid: 19648700
references.citation: J Natl Cancer Inst. 2008 May 7;100(9):630-41
references.pmid: 18445825
references.citation: J Clin Oncol. 2007 Jan 10;25(2):228-32
references.pmid: 17210945
references.citation: Clin J Oncol Nurs. 2004 Jun;8(3):279-87
references.pmid: 15208822
references.citation: Health Serv Res. 2002 Oct;37(5):1309-28
references.pmid: 12479498
references.citation: Cancer Pract. 2002 Sep-Oct;10(5):248-55
references.pmid: 12236838
references.citation: Women Health. 2002;36(1):1-20
references.pmid: 12215000
references.citation: Psychooncology. 2005 May;14(5):351-60
references.pmid: 15386763
references.citation: Pediatr Nurs. 1992 May-Jun;18(3):285-8
references.pmid: 1625958
references.citation: Oncol Nurs Forum. 2007 Sep;34(5):1007-16
references.pmid: 17878129
references.citation: J Support Oncol. 2004 May-Jun;2(3):271-8
references.pmid: 15328826
references.citation: J Natl Cancer Inst. 2007 Jan 3;99(1):14-23
references.pmid: 17202109
references.citation: Palliat Med. 2007 Oct;21(7):595-607
references.pmid: 17942498
references.citation: Cancer Pract. 1994 May-Jun;2(3):187-93
references.pmid: 8055022
references.citation: Cancer. 2008 Feb 1;112(3):616-25
references.pmid: 18085642
references.citation: Value Health. 2004 Mar-Apr;7(2):186-94
references.pmid: 15164808
references.citation: Am J Manag Care. 2009 Nov;15(11):801-6
references.pmid: 19895184
references.citation: Cancer Nurs. 2008 Nov-Dec;31(6):470-7
references.pmid: 18987515
references.citation: Oncol Nurs Forum. 1998 Oct;25(9):1615-22
references.pmid: 9802056
references.citation: Qual Life Res. 2010 Mar;19(2):177-89
references.pmid: 20094806