title: Evaluation of the costs and resource use associated with adjuvant chemotherapy for breast cancer in France.
abstract: OBJECTIVE
  There is a paucity of recent data on breast cancer costs, particularly on the burden of chemotherapy. The present study was designed to estimate resource use and costs associated with the current standard of care for adjuvant chemotherapy for breast cancer.
  
  
  METHODS
  Costs and resource use were assessed by retrospective analysis of medical records at a single comprehensive cancer care center, Hôpital Tenon, Paris, France. Data were extracted from files of female patients having undergone surgical resection of breast cancer between January-July 2010. Patients were included if they received chemotherapy at the hospital and had medical records available. Patients were followed from the start of adjuvant chemotherapy (including pre-chemotherapy) to the end of treatment. Costs were collected for each resource use item from a societal perspective using standard, published sources and expressed in 2011 Euros (€). Limitations of the analysis included the single-center study design and the use of pre-defined questionnaires on resource use (which may conservatively estimate costs).
  
  
  RESULTS
  A total of 62 patients were included in the study with a mean age of ∼54 years. Most patients had stage II (50.8%) or stage III (40.7%) disease. Anthracycline plus taxane-based chemotherapy regimens were most commonly prescribed (77% of patients). Mean cost of adjuvant chemotherapy was estimated to be ∼€15,740 per patient from a societal perspective. The acquisition costs of chemotherapy agents were responsible for 26% of the total, with lost productivity (27%), chemotherapy administration (19%), and adverse events (16%) also contributing substantially.
  
  
  CONCLUSIONS
  Evaluation of costs in patients with non-metastatic breast cancer in France has shown that the costs of adjuvant chemotherapy are substantial. The main components of total cost were the cost of chemotherapy agents, lost productivity, chemotherapy administration, and management and prevention of adverse events.
authors.affiliation: Université Pierre et Marie Curie, Paris 6, INSERM-UMR S 938, ER2-Prediction Unit, Hôpital Tenon, Gynécologie-Obstétrique et Médecine de la Reproduction, Paris, France.
authors.forename: Enora
authors.initials: E
authors.lastname: Laas
authors.forename: Anne-Lise
authors.initials: AL
authors.lastname: Vataire
authors.forename: Samuel
authors.initials: S
authors.lastname: Aballea
authors.forename: William
authors.initials: W
authors.lastname: Valentine
authors.forename: Joseph
authors.initials: J
authors.lastname: Gligorov
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Chereau
authors.forename: Roman
authors.initials: R
authors.lastname: Rouzier
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000191:economics; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects / Q000191:economics* / Q000379:methods; D003365:Costs and Cost Analysis; D005260:Female; D005602:France; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review; D008875:Middle Aged; D012189:Retrospective Studies