Estimates of the lifetime direct costs of treatment for metastatic breast cancer.
Estimates of the lifetime direct costs of treatment for metastatic breast cancer.
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DOI：
10.1046/j.1524-4733.2000.31003.x
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发表时间：
2000-01-01
期刊：
影响因子：
--
通讯作者：
Silberman, G
中科院分区：
文献类型：
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作者：
Berkowitz, N;Gupta, S;Silberman, G
目的：乳腺癌仍然是美国女性中发病率最高的癌症，先前的研究表明，相当一部分患者最终将进展到疾病的转移期。本文提供了第一次估计的一生中的直接费用治疗转移性疾病的一个年度诊断队列的乳腺癌patient.METHODS：发病率与美国人口计数相结合，估计在1994年诊断的乳腺癌病例数。进展至转移性疾病的估计值（来自加拿大省级癌症登记数据），护理费用（来自患者的索赔历史），生存期（来自SEER数据）和国家死亡率（来自美国人口普查局）进行了整合，使用加拿大统计局的人口健康模型（POHEM）计算终身成本。这项研究估计，超过40%的乳腺癌患者会发展为转移性疾病。平均而言，转移性疾病的妇女预计将生活3年，并承担直接治疗费用约60，000美元每例，在一个总的终身成本的队列近4.2亿美元。结论：乳腺癌复发率高，主张发展干预措施，可以预防或延迟转移性疾病的发生。这些终生费用估计数及其所依据的方法可用于评价这种二级预防战略的成本效益。这些估计数也可以作为基准，用于评估治疗其他疾病的终生费用。
OBJECTIVE: Breast cancer remains the highest incident cancer among females in the United States and previous research suggests that a considerable portion of patients will eventually progress to the metastatic phase of the disease. This paper provides the first estimate of the lifetime direct costs of treating metastatic disease for one annual diagnostic cohort of breast cancer patients.METHODS: Incidence rates were combined with US population counts to estimate the number of breast cancer cases diagnosed in 1994. Estimates of progression to metastatic disease (from Canadian provincial cancer registry data), costs of care (derived from patients' claims histories), survival (from SEER data), and national mortality rates (from US Census Bureau) were integrated, using Statistics Canada's Population Health Model (POHEM) to calculate lifetime costs.RESULTS: This study estimates that more than 40% of the women diagnosed with breast cancer will progress to metastatic disease. On average, women with metastatic disease are expected to live 3 years and to incur direct treatment costs of approximately dollar 60,000 per case, resulting in a total lifetime cost for the cohort of almost dollar 4.2 billion.CONCLUSIONS: The high rate of recurrence of breast cancer argues for the development of interventions that can prevent or delay the onset of metastatic disease. These estimates of lifetime costs and the methodology on which they are based can be used to evaluate the cost-effectiveness of such secondary prevention strategies. These estimates also can serve as a benchmark against which the lifetime costs of treating other diseases can be assessed.