Healthcare costs in women with metastatic breast cancer receiving chemotherapy as their principal treatment modality.
Healthcare costs in women with metastatic breast cancer receiving chemotherapy as their principal treatment modality.
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DOI：
10.1186/1471-2407-11-250
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发表时间：
2011-06-15
期刊：
影响因子：
3.8
通讯作者：
Oster G
中科院分区：
文献类型：
--
作者：
Vera-Llonch M;Weycker D;Glass A;Gao S;Borker R;Qin A;Oster G
治疗转移性乳腺癌患者的经济成本已经在几项研究中进行了调查，但现有的经济负担估计至少是十年前的。在这项研究中，我们描述了美国接受化疗作为主要治疗方式的转移性乳腺癌妇女的医疗保健利用和成本。使用大型私人健康保险索赔数据库（2000-2006），我们确定了所有因转移性乳腺癌而开始化疗的女性，没有证据表明她们接受了同时或随后的激素治疗，也没有任何时候接受曲妥珠单抗。从化疗开始日期（“索引日期”）到健康计划退出日期或研究期结束日期（以先发生者为准），以累积的基础估计医疗保健利用和费用（住院、门诊、药物）。使用Kaplan-Meier样本平均（KMSA）方法随时间累积研究测量值；95% ci采用非参数自举法生成。研究结果还在未审查数据的患者亚组中进行了检查。研究人群包括1444名女性；平均（SD）年龄为59.1（12.1）岁。在平均532天的随访期间（范围：3至2412天），研究对象平均1.7次住院，10.7天住院，83.6次医生办公室和医院门诊就诊。平均（95% CI）累积总医疗成本为每位患者128,556美元（118,409美元，137,644美元）。门诊服务占总费用的29%，其次是化疗以外的药物（26%）、化疗（25%）和住院治疗（20%）。对于除了化疗以外的治疗选择有限的转移性乳腺癌妇女来说，医疗保健费用——尤其是门诊费用——是相当可观的。
The economic costs of treating patients with metastatic breast cancer have been examined in several studies, but available estimates of economic burden are at least a decade old. In this study, we characterize healthcare utilization and costs in the US among women with metastatic breast cancer receiving chemotherapy as their principal treatment modality. Using a large private health insurance claims database (2000-2006), we identified all women initiating chemotherapy for metastatic breast cancer with no evidence of receipt of concomitant or subsequent hormonal therapy, or receipt of trastuzumab at anytime. Healthcare utilization and costs (inpatient, outpatient, medication) were estimated on a cumulative basis from date of chemotherapy initiation ("index date") to date of disenrollment from the health plan or the end of the study period, whichever occurred first. Study measures were cumulated over time using the Kaplan-Meier Sample Average (KMSA) method; 95% CIs were generated using nonparametric bootstrapping. Findings also were examined among the subgroup of patients with uncensored data. The study population consisted of 1444 women; mean (SD) age was 59.1 (12.1) years. Over a mean follow-up of 532 days (range: 3 to 2412), study subjects averaged 1.7 hospital admissions, 10.7 inpatient days, and 83.6 physician office and hospital outpatient visits. Mean (95% CI) cumulative total healthcare costs were $128,556 ($118,409, $137,644) per patient. Outpatient services accounted for 29% of total costs, followed by medication other than chemotherapy (26%), chemotherapy (25%), and inpatient care (20%). Healthcare costs-especially in the outpatient setting--are substantial among women with metastatic breast cancer for whom treatment options other than chemotherapy are limited.