title: Healthcare cost attributable to recently-diagnosed breast cancer in a privately-insured population in the United States.
abstract: OBJECTIVE
  To evaluate breast cancer-associated healthcare cost from the payer perspective for the initial year after diagnoses of invasive breast cancer.
  
  
  BACKGROUND
  Breast cancer is the second most common malignancy in American women. While lifetime burden-of-care studies have reported spending between $20,000 and $100,000 per patient, previous studies have not outlined first year cost in managing this disease in recently diagnosed patients.
  
  
  METHODS
  This study was a retrospective, matched cohort study of privately-insured patients. Data were from a large US employers' health claims database (January 2003-September 2008). Breast cancer cases were identified by ICD-9-CM diagnostic codes on index and confirmatory claims. A control group was identified with a ratio of 3:1, matched by demographic and health plan characteristics. Comorbidities were analyzed using the Charlson comorbidity index and AHRQ Comorbidity Software. A multivariate, log-linked, generalized linear model evaluated cost contributions of breast cancer in relation to demographic factors, comorbidities, and plan type.
  
  
  RESULTS
  The study included 35,057 cases and 105,171 matched controls (mean age 52 years). Common comorbidities included hypertension, diabetes, hypothyroidism, chronic pulmonary disease, and deficiency anemia. In the generalized linear model, the adjusted difference in total healthcare cost was $42,401 per patient within a year, with outpatient services responsible for most of this sum. Breast cancer-associated incremental annual costs per patient in inpatient, outpatient, and prescription categories were $5100, $37,231, and $1037, respectively.
  
  
  CONCLUSIONS
  These results may not be representative of the entire US, as data were derived from breast cancer patients with private, employer-based health insurance, and lacked covariates including race/ethnicity, education, income, and disease stage.
  
  
  CONCLUSIONS
  Recently diagnosed breast cancer represents a substantial economic burden for US healthcare payers.
authors.affiliation: Cancer Prevention and Control Program, Georgetown University Medical Center, Washington, DC 20007, USA. zf54@georgetown.edu
authors.forename: Alex Z
authors.initials: AZ
authors.lastname: Fu
authors.forename: Mehul
authors.initials: M
authors.lastname: Jhaveri
mesh_terms: D001943:Breast Neoplasms / Q000191:economics*; D015331:Cohort Studies; D017281:Cost of Illness; D016208:Databases, Factual; D005260:Female; D005102:Health Expenditures; D006801:Humans; D007345:Insurance Claim Review; D019458:Insurance Coverage / Q000191:economics*; D007348:Insurance, Health / Q000191:economics*; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States