title: Cost of treatment for breast cancer in central Vietnam.
abstract: BACKGROUND
  In recent years, cases of breast cancer have been on the rise in Vietnam. To date, there has been no study on the financial burden of the disease. This study estimates the direct medical cost of a 5-year treatment course for women with primary breast cancer in central Vietnam.
  
  
  METHODS
  Retrospective patient-level data from medical records at the Hue Central Hospital between 2001 and 2006 were analyzed. Cost analysis was conducted from the health care payers' perspective. Various direct medical cost categories were computed for a 5-year treatment course for patients with breast cancer. Costs, in US dollars, discounted at a 3% rate, were converted to 2010 after adjusting for inflation. For each cost category, the mean, standard deviation, median, and cost range were estimated. Median regression was used to investigate the relationship between costs and the stage, age at diagnosis, and the health insurance coverage of the patients.
  
  
  RESULTS
  The total direct medical cost for a 5-year treatment course for breast cancer in central Vietnam was estimated at $975 per patient (range: $11.7-$3,955). The initial treatment cost, particularly the cost of chemotherapy, was found to account for the greatest proportion of total costs (64.9%). Among the patient characteristics studied, stage at diagnosis was significantly associated with total treatment costs. Patients at later stages of breast cancer did not differ significantly in their total costs from those at earlier stages however, but their survival time was much shorter. The absence of health insurance was the main factor limiting service uptake.
  
  
  CONCLUSIONS
  From the health care payers' perspective, the Government subsidization of public hospital charges lowered the direct medical costs of a 5-year treatment course for primary breast cancer in central Vietnam. However, the long treatment course was significantly influenced by out-of-pocket payments for patients without health insurance.
authors: Graduate School, Khon Kaen University, Khon Kaen, Thailand.
authors: Nguyen
authors: N
authors: Hoang Lan
authors: Wongsa
authors: W
authors: Laohasiriwong
authors: John Frederick
authors: JF
authors: Stewart
authors: Nguyen Dinh
authors: ND
authors: Tung
authors: Peter C
authors: PC
authors: Coyte
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000191:economics; D001943:Breast Neoplasms / Q000191:economics* / Q000401:mortality; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006291:Health Policy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D014744:Vietnam / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents
keywords: Vietnam; breast cancer; direct medical cost; health care payer
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