title: Costs of breast cancer care in Mexico: analysis of two insurance coverage scenarios.
abstract: BACKGROUND
  Breast cancer (BC) is a major cause of disease and death worldwide. In addition to its contribution to mortality and disability, it is a major economic burden both public and private.
  
  
  OBJECTIVE
  To estimate the average direct medical cost/year of care for the diagnosis and treatment of BC in two coverage scenarios in Mexico: What is 'ideal' based on service usage patterns according to international guidelines and what is 'current' using the service usage patterns of suppliers in Mexico.
  
  
  METHODS
  The pattern and intensity of use of procedures for the care of BC in the Mexican Social Security Institute (IMSS) for 2009 were identified and prices were associated using the guidelines from the System of Social Protection in Health (SPSS) and the IMSS for the current scenario and the ideal scenario, international patterns (Breast Health Global Initiative BHGI after its acronym in English) were used and prices were associated from the SPSS guidelines.
  
  
  RESULTS
  The annual average direct medical cost per patient in the 'current' scenario was 8557 US$, while the cost in the 'ideal' scenario was 4554 US$. There are differences in costs between 'what we do' and 'what should be done', due to differences in the implementation of the interventions for the treatment of the different stages of the disease. A proportional increase in the average cost was also identified as the diagnosis stage advanced (from I to III).
  
  
  CONCLUSIONS
  Given that in Mexico there is universal insurance coverage for the treatment of BC, it is necessary to use economic resources more efficiently. It is necessary to continue to examine this topic in more depth and the next step will be to assess the effectiveness of both scenarios in order to provide enough evidence for the decision-making process.
authors.affiliation: Center for Research in Health Systems, National Institute of Public Health, Av. Universidad 655 cerr. Los Pinos y Caminera, Col. Santa María Ahuacatitlán C.P. 62100, Cuernavaca, Morelos, Mexico.
authors.forename: María Cecilia
authors.initials: MC
authors.lastname: González-Robledo
authors.affiliation: WHO Collaborating Centre/PAHO Aging and Health, University of Texas Medical Branch, Texas, USA.
authors.forename: Rebeca
authors.initials: R
authors.lastname: Wong
authors.affiliation: Economic Research and Research Promotion Council of Competitiveness and Health, Mexican Health Foundation, Mexico.
authors.forename: Héctor Arreola
authors.initials: HA
authors.lastname: Ornelas
authors.affiliation: Miami Institute of Americas & Miller School of Medicine, Miami University, Miami, USA; Mexican Health Foundation & Founding President of Tómatelo a Pecho A.C., México ; At the time of writing the paper, Director of the Harvard Global Equity Initiative at Harvard University.
authors.forename: Felicia Marie
authors.initials: FM
authors.lastname: Knaul
keywords: Mexico; breast neoplasms; direct service costs; health financing