title: Cost of breast cancer treatment in Medicaid: implications for state programs providing coverage for low-income women.
abstract: BACKGROUND
  To date, no study has reported on the cost of treating breast cancer among Medicaid beneficiaries younger than 65 years of age. This information is essential for assessing the funding required for treatment programs established by the Breast and Cervical Cancer Prevention and Treatment Act of 2000.
  
  
  OBJECTIVE
  This study assesses the incremental cost of breast cancer treatment among Medicaid beneficiaries aged below 65 years.
  
  
  METHODS
  Administrative data from the North Carolina Medicaid program linked with cancer registry data were analyzed to derive monthly Medicaid costs for cancer patients and the incremental costs of breast cancer treatment at 6, 12, and 24 months from diagnosis. We compared 848 beneficiaries diagnosed with cancer during the years 2002 to 2004 with 1696 comparison cases matched on age.
  
  
  RESULTS
  With the exception of in situ cancers, the cost of cancer care continued to increase beyond the initial 6-month period. The incremental costs at 6 months after diagnosis are $14,341, $24,002, and $34,469 for those with local, regional, and distant breast cancers, respectively; and these costs increased to $22,343, $41,005, and $117,033 at 24 months.
  
  
  CONCLUSIONS
  The extended period of health care utilization, beyond the immediate 6-month period after diagnosis, indicates that Medicaid coverage may be required for many months after diagnosis to complete treatment. Continuous Medicaid coverage should be provided for an adequate time period to ensure that complete and comprehensive treatment is provided.
authors.affiliation: RTI International, Waltham, MA 0245, USA. ssubramanian@rti.org
authors.forename: Sujha
authors.initials: S
authors.lastname: Subramanian
authors.forename: Justin
authors.initials: J
authors.lastname: Trogdon
authors.forename: Donatus U
authors.initials: DU
authors.lastname: Ekwueme
authors.forename: James G
authors.initials: JG
authors.lastname: Gardner
authors.forename: J Timothy
authors.initials: JT
authors.lastname: Whitmire
authors.forename: Chandrika
authors.initials: C
authors.lastname: Rao
mesh_terms: D000367:Age Factors; D001943:Breast Neoplasms / Q000191:economics* / Q000628:therapy*; D015897:Comorbidity; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008484:Medicaid; D008875:Middle Aged; D009367:Neoplasm Staging; D009657:North Carolina; D011203:Poverty / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013997:Time Factors; D014481:United States