74 Background: Breast cancer is the most common malignant tumor among women in the United States, accounting for about 30% of incident cancers. It is one of the most costly medical conditions to treat. Younger women aged 18-44 years account for 11% of new cases. These women tend to experience more aggressive types of breast cancer, requiring intensive and expensive treatment. In recent years, a few studies have examined the costs of breast cancer treatment in a Medicaid population at the state level. However, no study has estimated medical costs for breast cancer treatment at the national level for women aged 19-44 years enrolled in Medicaid. Methods: A sample of 5,542 younger women aged 19-44 years, fee-for-service Medicaid enrollees, and diagnosed with breast cancer in 2007 were compared with 4.3 million women aged 19-44 years, fee-for-service Medicaid enrollees, but without breast cancer. The study used linear and nonlinear regression methods to estimate treatment costs for younger women with breast cancer compared with those without breast cancer. Individual medical costs were estimated by race/ethnicity and by type of services. All medical treatment costs were adjusted to 2010 dollars. Results: The estimated annual direct medical costs for breast cancer treatment among younger women enrolled in Medicaid ranged from nearly $25,000 to $42,000 per woman. Non-Hispanic black women had the highest annual total medical costs, followed by Hispanic women, while non-Hispanic women of other race had the lowest. The cost estimates ranged from $14,600 to $18,800 for outpatient service, $4,600 to $5,700 for inpatient service, and $3,500 to $4,800 for prescription drugs. Conclusions: The cost estimates demonstrate the substantial medical costs associated with breast cancer treatment for younger Medicaid beneficiaries. As the Medicaid program continues to evolve, the treatment cost estimates could serve as important inputs in decision-making regarding planning for treatment of invasive breast cancer in this population.
Development of a method to determine the cost of breast cancer treatment with chemotherapy at Groote Schuur Hospital, Cape Town, South Africa
