RT Journal Article
SR Electronic
T1 Direct medical and non-medical costs of a one-year care pathway for early breast cancer: results of a French multicenter prospective study
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 514182
DO 10.1101/514182
A1 Delphine Héquet
A1 Cyrille Huchon
A1 Anne-Laure Soilly
A1 Bernard Asselain
A1 Hélène Berseneff
A1 Caroline Trichot
A1 Alix Combes
A1 Karine Alves
A1 Thuy Nguyen
A1 Roman Rouzier
A1 Sandrine Baffert
YR 2019
UL http://biorxiv.org/content/early/2019/01/09/514182.abstract
AB Introduction The organization of health care for breast (BC) constitutes a public health challenge to ensure quality of care, while also controlling expenditure. Few studies have assessed the global care pathway of early BC patients, including a description of direct medical costs and their determinants.Methods OPTISOINS01 was a multicenter, prospective, observational study including early BC patients from diagnosis to one-year follow-up. Direct medical costs (in-hospital and out-ofhospital costs, supportive care costs) and direct non-medical costs (transportation and sick leave costs) were calculated by using a cost-of-illness analysis based on a bottom-up approach. Resources consumed were recorded in situ for each patient, using a prospective direct observation method.Results Data from 604 patients were analyzed. Median direct medical costs of 1 year of management after diagnosis in operable BC patients were €12,250. Factors independently associated with higher direct medical costs were: diagnosis on the basis of clinical signs, invasive cancer, lymph node involvement and conventional hospitalization for surgery. Median sick leave costs were €8,841 per patient and per year. Chemotherapy was an independent determinant of sick leave costs (€3,687/patient/year without chemotherapy versus €10,706 with chemotherapy). Forty percent (n=242) of patients declared additional personal expenditure of €614/patient/year. No drivers of these costs were identified.Conclusion Initial stage of disease and the treatments administered were the main drivers of direct medical costs. Direct non-medical costs essentially consisted of sick leave costs, accounting for one-half of direct medical costs for working patients. Out-of-pocket expenditure had a limited impact on the household.