Adverse breast cancer treatment effects: the economic case for making rehabilitative programs standard of care

Kathryn H. Schmitz, Tracey DiSipio, Louisa G. Gordon, Sandra C. Hayes

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: The purpose of this work was to evaluate the patient-borne financial cost of common, adverse breast cancer treatment-associated effects, comparing cost across women with or without these side effects. Methods: Two hundred eighty-seven Australian women diagnosed with early-stage breast cancer were prospectively followed starting at 6 months post-surgery for 12 months, with three monthly assessments of detailed treatment-related side effects and their direct and indirect patient costs attributable to breast cancer. Bootstrapping statistics were used to analyze cost data, and adjusted logistic regression was used to evaluate the association between costs and adverse events from breast cancer. Costs were inflated and converted from 2002 Australian to 2014 US dollars. Results: More than 90 % of women experienced at least one adverse effect (i.e., post-surgical issue, reaction to radiotherapy, upper-body symptoms or reduced function, lymphedema, fatigue, or weight gain). On average, women paid $5,636 (95 % confidence interval (CI), $4,694, $6,577) in total costs. Women with any one of the following symptoms (fatigue, reduced upper-body function, upper-body symptoms) or women who report ≥4 adverse treatment-related effects, have 1.5 to nearly 4 times the odds of having higher healthcare costs than women who do not report these complaints (p < 0.05). Conclusions: Women face substantial economic burden due to a range of treatment-related health problems, which may persist beyond the treatment period. Improving breast cancer care by incorporating prospective surveillance of treatment-related side effects and strategies for prevention and treatment of concerns (e.g., exercise) has real potential for reducing patient-borne costs.

Original languageEnglish (US)
Pages (from-to)1807-1817
Number of pages11
JournalSupportive Care in Cancer
Volume23
Issue number6
DOIs
StatePublished - Jun 1 2015

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Standard of Care
Economics
Breast Neoplasms
Costs and Cost Analysis
Therapeutics
Fatigue
Lymphedema
Health Care Costs
Weight Gain
Radiotherapy
Logistic Models
Confidence Intervals
Exercise
Health

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Schmitz, Kathryn H. ; DiSipio, Tracey ; Gordon, Louisa G. ; Hayes, Sandra C. / Adverse breast cancer treatment effects : the economic case for making rehabilitative programs standard of care. In: Supportive Care in Cancer. 2015 ; Vol. 23, No. 6. pp. 1807-1817.
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Adverse breast cancer treatment effects : the economic case for making rehabilitative programs standard of care. / Schmitz, Kathryn H.; DiSipio, Tracey; Gordon, Louisa G.; Hayes, Sandra C.

In: Supportive Care in Cancer, Vol. 23, No. 6, 01.06.2015, p. 1807-1817.

Research output: Contribution to journalArticle

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T2 - the economic case for making rehabilitative programs standard of care

AU - Schmitz, Kathryn H.

AU - DiSipio, Tracey

AU - Gordon, Louisa G.

AU - Hayes, Sandra C.

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AB - Purpose: The purpose of this work was to evaluate the patient-borne financial cost of common, adverse breast cancer treatment-associated effects, comparing cost across women with or without these side effects. Methods: Two hundred eighty-seven Australian women diagnosed with early-stage breast cancer were prospectively followed starting at 6 months post-surgery for 12 months, with three monthly assessments of detailed treatment-related side effects and their direct and indirect patient costs attributable to breast cancer. Bootstrapping statistics were used to analyze cost data, and adjusted logistic regression was used to evaluate the association between costs and adverse events from breast cancer. Costs were inflated and converted from 2002 Australian to 2014 US dollars. Results: More than 90 % of women experienced at least one adverse effect (i.e., post-surgical issue, reaction to radiotherapy, upper-body symptoms or reduced function, lymphedema, fatigue, or weight gain). On average, women paid $5,636 (95 % confidence interval (CI), $4,694, $6,577) in total costs. Women with any one of the following symptoms (fatigue, reduced upper-body function, upper-body symptoms) or women who report ≥4 adverse treatment-related effects, have 1.5 to nearly 4 times the odds of having higher healthcare costs than women who do not report these complaints (p < 0.05). Conclusions: Women face substantial economic burden due to a range of treatment-related health problems, which may persist beyond the treatment period. Improving breast cancer care by incorporating prospective surveillance of treatment-related side effects and strategies for prevention and treatment of concerns (e.g., exercise) has real potential for reducing patient-borne costs.

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