title: Breast cancer attributable costs in Germany: a top-down approach based on sickness funds data.
abstract: BACKGROUND
  Breast cancer is the leading cause of death from cancer among women in Germany. Despite its clinical and economic relevance, no attributable costs for breast cancer have been reported for Germany so far. The objective of this study is to estimate age-specific breast cancer attributable health expenditures for Germany.
  
  
  METHODS
  Sickness fund data from 1999 representing about 26 million insured (i.e. 32% of the total German population) have been analysed using generalized additive models and the error propagation law. Costs have been inflated to 2010.
  
  
  RESULTS
  Breast cancer attributable costs decreased with age. Among breast cancer patients aged 30-45 years, about 90% of all health expenditures were due to breast cancer, whereas in breast cancer patients aged 80-90 years, about 50% were due to breast cancer. Breast cancer attributable costs amounted to about €9,000 annually for patients below 55 years of age and declined to about €3,000 in 90-year-old breast cancer patients.
  
  
  CONCLUSIONS
  This analysis provides estimates of attributable breast cancer costs in Germany. Compared with the international literature, the estimates were plausible but had a tendency to underestimate breast cancer attributable costs.
authors.affiliation: Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany.
authors.forename: Emil Victor
authors.initials: EV
authors.lastname: Gruber
authors.forename: Stephanie
authors.initials: S
authors.lastname: Stock
authors.forename: Björn
authors.initials: B
authors.lastname: Stollenwerk
mesh_terms: D001943:Breast Neoplasms / Q000191:economics* / Q000453:epidemiology; D017281:Cost of Illness; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans