title: Incidence-based cost-of-illness model for metastatic breast cancer in the United States.
abstract: OBJECTIVE
  This study aims to estimate the annual U.S. societal costs associated with treatment of metastatic breast cancer (MBC) patients using an incidence-based cost-of-illness (COI) framework.
  
  
  METHODS
  An incidence-based COI model was constructed in which MBC patients were simulated from diagnosis through active treatment, palliative care, and death over 5 years. Key model parameters included: annual incidence of breast cancer in the metastatic stage, utilization of cancer therapies and other medical care resources, treatment-related adverse events, unit costs, work days missed by patient and caregiver, and wage rates. Overall survival was based on SEER data and costs were assigned to living patients monthly, according to their disease management phase. The outcomes measures were total discounted societal costs, cost/year, and cost/patient-year.
  
  
  RESULTS
  The annual incidence of MBC in the United States in 2007 was estimated to be 49,674 patients (de novo and progressed from earlier stages). The total discounted cost to society attributable to MBC was $12.2 billion for the incident cohort, or $98,571 per patient-year. The 5-year direct medical cost of this incident cohort was $9.3 billion, or $75,415 per patient-year. Treatment-related costs (active treatment, toxicity management, and medical follow-up) contributed 44 percent of MBC expenditure, followed by palliative/best supportive care costs (31 percent). Lost productivity accounted for approximately 21 percent of the total cost ($2.6 billion over 5 years or $21,153 per patient-year).
  
  
  CONCLUSIONS
  The societal burden of MBC in the United States is substantial. Earlier detection and effective treatment could lead to a significant decrease in costs while improving overall disease prognosis.
authors.affiliation: United BioSource Corporation. sonja.sorensen@unitedbiosource.com
authors.forename: Sonja V
authors.initials: SV
authors.lastname: Sorensen
authors.forename: Jo Wern
authors.initials: JW
authors.lastname: Goh
authors.forename: Feng
authors.initials: F
authors.lastname: Pan
authors.forename: Connie
authors.initials: C
authors.lastname: Chen
authors.forename: Denise
authors.initials: D
authors.lastname: Yardley
authors.forename: Miguel
authors.initials: M
authors.lastname: Martín
authors.forename: Kevin
authors.initials: K
authors.lastname: Knopf
authors.forename: Agnes
authors.initials: A
authors.lastname: Benedict
authors.forename: Carla
authors.initials: C
authors.lastname: Giorgetti
authors.forename: Shrividya
authors.initials: S
authors.lastname: Iyer
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000191:economics* / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D018426:SEER Program; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents