Vast Cost Difference Between Breast Cancer Treatments

A recent study suggests that different breast cancer chemotherapies vary greatly in cost regardless of efficacy. Researchers found that choosing a treatment that is as effective but less expensive could save $1 billion per year.

"The costs of cancer care have been increasing dramatically, both for the health care system and for patients. As physicians, we increasingly are recognizing the financial burden on our patients," said researcher Sharon Giordano, MD. "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."

Researchers included claims gathered from the MarketScan database from 14,643 women diagnosed with breast cancer between 2008 and 2012, according to a study presented at the 2016 American Society of Clinical Oncology Annual Meeting. They then calculated the average total and out-of-pocket costs for claims filed within 18 months of diagnoses.

Separate analyses were conducted for treatments that included trastuzumab and those that did not.

"In this study, we found substantial variation in the costs of breast cancer treatment for different chemotherapy regimens, even when comparing treatments of similar efficacy," Dr Giordano said.

For patients who did not receive treatment with trastuzumab, the median insurance payments were $82,260 and median out-of-pocket costs were $2727. For patients treated with trastuzumab, median insurance payments were $160,590 and median out-of-pocket costs were $3381, according to the study.

"When considering all patients, we did not see large variations in out-of-pocket costs across different chemotherapy regimens, but some individuals did have high out-of-pocket costs," Dr Giordano said. “Patients who were enrolled in high-deductible health plans had median out-of-pocket payments of over $5000."

However, researchers note that the study was limited due to its focus on younger patients who had private insurance and that patients without private insurance are likely to have higher costs. They were also unable to find the costs of novel drugs and they relied on just insurance claims. Researchers also were unable to use cancer registry data for stage, patient race, or tumor characteristics, according to the study.

"Oncology providers need to continue to move toward the goal of providing high value care that is aligned with our patients' goals and preferences," concluded Dr Giordano. "I hope this study will make providers more aware of the substantial financial burden associated with chemotherapy treatments so that they may work with their patients to identify the best options available."