Breast cancer costs can vary by tens of thousands of dollars in the United States, depending on the course of treatment doctors select, a new study finds.
The research published Monday online in Cancer also found treatment costs don’t necessarily reflect effectiveness.
The American Cancer Society estimates 246,660 new cases of invasive breast cancer will be diagnosed in the United States this year. Costs range into the tens of thousands of dollars.
“We found a wide variation in costs between these regimens, which could result in unnecessary costs to both patients and the health care system,” Dr. Sharon Giordan, lead author, said in a press release. “We also found that many patients had high out of pocket costs for their care.”
Giordano noted the cost of care has been increasing dramatically.
“As physicians, we increasingly recognize the financial burden on our patients,” she said. “Both physicians and patients need greater access to information about the treatment costs so this critical issue can be discussed during a patient’s decision-making process.”
More than a third of patients with breast cancer undergo chemotherapy in addition to surgery and/or radiation. The researchers estimate $1 billion could be saved nationally every year if less costly but equally effective regimens are chosen.
The researchers examined 14,643 insurance claims in the MarketScan database filed by women with full insurance coverage from 2008 to 2012. The subjects received chemotherapy within three months of diagnosis and had no secondary malignancy within a year. Median insurance payments totaled $82,260 for patients who did not receive trastuzumab, but that total varied by as much as $20,354.
For the patients, median out-of-pocket costs totaled $2,727 but more than 10 percent paid more than $7,041.
The costs were even higher for patients receiving trastuzumab, with median insurance payments soaring to $160,590 with a variance of $46,936 for the most common regimen. The median out-of-pocket cost for patients rose to $3,381, with 10 percent of patients paying more than $89,384.
The study did not include costs of new therapies. Nor were cancer stage, patient race or ethnicity, or tumor characteristics considered.
Laura F. Nixon