Estimating regimen-specific costs of chemotherapy for breast cancer: Observational cohort study

Sharon H. Giordano, Jiangong Niu, Mariana Chavez-MacGregor, Hui Zhao, Daria Zorzi, Ya Chen Tina Shih, Benjamin D. Smith, Chan Shen

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

BACKGROUND: One goal for high-quality patient care is communicating treatment costs to patients, yet cost information can be elusive. This is especially relevant for breast cancer care, for which numerous guideline-concordant adjuvant chemotherapy regimens exist. The objective of the current study was to generate cost estimates for such regimens from payers’ and patients’ perspectives in a large, insured US population. METHODS: Adult women who had incident breast cancer diagnosed between 2008 and 2012 (from the MarketScan database), had no secondary malignancy within 1 year of diagnosis, and received chemotherapy within 3 months of diagnosis were included (n = 14,643). Total and out-of-pocket costs were calculated using all claims within 18 months of diagnosis and were normalized to 2013 US dollars. The extended estimating equations method was used to assess cost by regimen adjusting for demographic and clinical factors. RESULTS: Among patients who did and did not receive trastuzumab, the median insurance payments were $160,590 and $82,260, respectively, and the median out-of-pocket payments were $3381 and $2724, respectively. Among patients who did not receive trastuzumab, 25% paid more than $4712, and 10% of patients paid more than $7041. For patients who did receive trastuzumab, 25% paid more than $5604, and 10% paid more than $8384. Among patients who were covered by high-deductible health plans, the median out-of-pocket cost was $5158, 25% paid at least $8128, and 10% paid ≥ $11,344. CONCLUSIONS: The costs of breast cancer chemotherapy vary widely across regimens, and patients bear a substantial out-of-pocket burden. Cancer 2016;122:3447–3455.

Original languageEnglish (US)
Pages (from-to)3447-3455
Number of pages9
JournalCancer
Volume122
Issue number22
DOIs
StatePublished - Nov 15 2016

Fingerprint

Observational Studies
Cohort Studies
Breast Neoplasms
Costs and Cost Analysis
Drug Therapy
Health Expenditures
Deductibles and Coinsurance
Quality of Health Care
Adjuvant Chemotherapy
Insurance
Health Care Costs
Neoplasms
Patient Care
Demography
Databases
Guidelines
Health
Population
Trastuzumab

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Giordano, S. H., Niu, J., Chavez-MacGregor, M., Zhao, H., Zorzi, D., Shih, Y. C. T., ... Shen, C. (2016). Estimating regimen-specific costs of chemotherapy for breast cancer: Observational cohort study. Cancer, 122(22), 3447-3455. https://doi.org/10.1002/cncr.30274
Giordano, Sharon H. ; Niu, Jiangong ; Chavez-MacGregor, Mariana ; Zhao, Hui ; Zorzi, Daria ; Shih, Ya Chen Tina ; Smith, Benjamin D. ; Shen, Chan. / Estimating regimen-specific costs of chemotherapy for breast cancer : Observational cohort study. In: Cancer. 2016 ; Vol. 122, No. 22. pp. 3447-3455.
@article{fa98d769f3fa49e9a6b75136468a4abf,
title = "Estimating regimen-specific costs of chemotherapy for breast cancer: Observational cohort study",
abstract = "BACKGROUND: One goal for high-quality patient care is communicating treatment costs to patients, yet cost information can be elusive. This is especially relevant for breast cancer care, for which numerous guideline-concordant adjuvant chemotherapy regimens exist. The objective of the current study was to generate cost estimates for such regimens from payers’ and patients’ perspectives in a large, insured US population. METHODS: Adult women who had incident breast cancer diagnosed between 2008 and 2012 (from the MarketScan database), had no secondary malignancy within 1 year of diagnosis, and received chemotherapy within 3 months of diagnosis were included (n = 14,643). Total and out-of-pocket costs were calculated using all claims within 18 months of diagnosis and were normalized to 2013 US dollars. The extended estimating equations method was used to assess cost by regimen adjusting for demographic and clinical factors. RESULTS: Among patients who did and did not receive trastuzumab, the median insurance payments were $160,590 and $82,260, respectively, and the median out-of-pocket payments were $3381 and $2724, respectively. Among patients who did not receive trastuzumab, 25{\%} paid more than $4712, and 10{\%} of patients paid more than $7041. For patients who did receive trastuzumab, 25{\%} paid more than $5604, and 10{\%} paid more than $8384. Among patients who were covered by high-deductible health plans, the median out-of-pocket cost was $5158, 25{\%} paid at least $8128, and 10{\%} paid ≥ $11,344. CONCLUSIONS: The costs of breast cancer chemotherapy vary widely across regimens, and patients bear a substantial out-of-pocket burden. Cancer 2016;122:3447–3455.",
author = "Giordano, {Sharon H.} and Jiangong Niu and Mariana Chavez-MacGregor and Hui Zhao and Daria Zorzi and Shih, {Ya Chen Tina} and Smith, {Benjamin D.} and Chan Shen",
year = "2016",
month = "11",
day = "15",
doi = "10.1002/cncr.30274",
language = "English (US)",
volume = "122",
pages = "3447--3455",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "22",

}

Giordano, SH, Niu, J, Chavez-MacGregor, M, Zhao, H, Zorzi, D, Shih, YCT, Smith, BD & Shen, C 2016, 'Estimating regimen-specific costs of chemotherapy for breast cancer: Observational cohort study', Cancer, vol. 122, no. 22, pp. 3447-3455. https://doi.org/10.1002/cncr.30274

Estimating regimen-specific costs of chemotherapy for breast cancer : Observational cohort study. / Giordano, Sharon H.; Niu, Jiangong; Chavez-MacGregor, Mariana; Zhao, Hui; Zorzi, Daria; Shih, Ya Chen Tina; Smith, Benjamin D.; Shen, Chan.

In: Cancer, Vol. 122, No. 22, 15.11.2016, p. 3447-3455.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Estimating regimen-specific costs of chemotherapy for breast cancer

T2 - Observational cohort study

AU - Giordano, Sharon H.

AU - Niu, Jiangong

AU - Chavez-MacGregor, Mariana

AU - Zhao, Hui

AU - Zorzi, Daria

AU - Shih, Ya Chen Tina

AU - Smith, Benjamin D.

AU - Shen, Chan

PY - 2016/11/15

Y1 - 2016/11/15

N2 - BACKGROUND: One goal for high-quality patient care is communicating treatment costs to patients, yet cost information can be elusive. This is especially relevant for breast cancer care, for which numerous guideline-concordant adjuvant chemotherapy regimens exist. The objective of the current study was to generate cost estimates for such regimens from payers’ and patients’ perspectives in a large, insured US population. METHODS: Adult women who had incident breast cancer diagnosed between 2008 and 2012 (from the MarketScan database), had no secondary malignancy within 1 year of diagnosis, and received chemotherapy within 3 months of diagnosis were included (n = 14,643). Total and out-of-pocket costs were calculated using all claims within 18 months of diagnosis and were normalized to 2013 US dollars. The extended estimating equations method was used to assess cost by regimen adjusting for demographic and clinical factors. RESULTS: Among patients who did and did not receive trastuzumab, the median insurance payments were $160,590 and $82,260, respectively, and the median out-of-pocket payments were $3381 and $2724, respectively. Among patients who did not receive trastuzumab, 25% paid more than $4712, and 10% of patients paid more than $7041. For patients who did receive trastuzumab, 25% paid more than $5604, and 10% paid more than $8384. Among patients who were covered by high-deductible health plans, the median out-of-pocket cost was $5158, 25% paid at least $8128, and 10% paid ≥ $11,344. CONCLUSIONS: The costs of breast cancer chemotherapy vary widely across regimens, and patients bear a substantial out-of-pocket burden. Cancer 2016;122:3447–3455.

AB - BACKGROUND: One goal for high-quality patient care is communicating treatment costs to patients, yet cost information can be elusive. This is especially relevant for breast cancer care, for which numerous guideline-concordant adjuvant chemotherapy regimens exist. The objective of the current study was to generate cost estimates for such regimens from payers’ and patients’ perspectives in a large, insured US population. METHODS: Adult women who had incident breast cancer diagnosed between 2008 and 2012 (from the MarketScan database), had no secondary malignancy within 1 year of diagnosis, and received chemotherapy within 3 months of diagnosis were included (n = 14,643). Total and out-of-pocket costs were calculated using all claims within 18 months of diagnosis and were normalized to 2013 US dollars. The extended estimating equations method was used to assess cost by regimen adjusting for demographic and clinical factors. RESULTS: Among patients who did and did not receive trastuzumab, the median insurance payments were $160,590 and $82,260, respectively, and the median out-of-pocket payments were $3381 and $2724, respectively. Among patients who did not receive trastuzumab, 25% paid more than $4712, and 10% of patients paid more than $7041. For patients who did receive trastuzumab, 25% paid more than $5604, and 10% paid more than $8384. Among patients who were covered by high-deductible health plans, the median out-of-pocket cost was $5158, 25% paid at least $8128, and 10% paid ≥ $11,344. CONCLUSIONS: The costs of breast cancer chemotherapy vary widely across regimens, and patients bear a substantial out-of-pocket burden. Cancer 2016;122:3447–3455.

UR - http://www.scopus.com/inward/record.url?scp=84994235589&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84994235589&partnerID=8YFLogxK

U2 - 10.1002/cncr.30274

DO - 10.1002/cncr.30274

M3 - Article

AN - SCOPUS:84994235589

VL - 122

SP - 3447

EP - 3455

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 22

ER -

Giordano SH, Niu J, Chavez-MacGregor M, Zhao H, Zorzi D, Shih YCT et al. Estimating regimen-specific costs of chemotherapy for breast cancer: Observational cohort study. Cancer. 2016 Nov 15;122(22):3447-3455. https://doi.org/10.1002/cncr.30274