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APHA Scientific Session and Event Listing

Wendy Max, PhD, Hai-Yen Sung, PhD, Sandhya Sapra, PhD, and Lue-Yen Tucker. Institute for Health & Aging, University of California, San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94118, 415 476-8023, wendy.max@ucsf.edu

This study is focusing on the cost of breast cancer in California. It has two objectives. The first objective is to estimate the annual costs of breast cancer for California women for 2001, including direct health care costs of women with primary and secondary diagnoses of breast cancer, the value of time lost from paid employment and household production, and the value of lives lost prematurely. The second objective of the study is to estimate the lifetime Medicare cost of breast cancer for California women. Lifetime costs are estimated by comparing the total lifetime Medicare expenditures for women with and without breast cancer who are statistically the same in terms of socioeconomic and other characteristics. The difference between these costs is the lifetime cost of breast cancer.

In 2001, there were 12,934 hospital discharges of women with a primary diagnosis of breast cancer in California. The average length of stay was 2.2 days, the mean cost was $5967, and total costs were $77 million. Mean costs decreased with age and were greatest for MediCal recipients. Hospitalization costs for women with a secondary diagnosis of breast cancer added $29 million, or $4328 per discharge. Hospital outpatient visits totaled $69 million and office-based provider visits totaled $56 million. Prescription medications and nursing home care added $19 million and $15 million in costs respectively. The total direct costs of breast cancer in California for 2001 were $279 million. In addition, breast cancer claimed the lives of 4226 women. Many of these women were relatively young, with 46% being under age 65. These deaths represented a total of $1.1 billion in lost productivity and nearly 100,000 lost years of life.

We have now developed a cohort of 13,821 California breast cancer patients to be used for the analysis of lifetime costs. The majority of the patients in the cohort are white (82%). Hispanics and blacks accounted for 6% and 7% respectively. 39% of these patients were classified as stage 1 according to the Modified AJC stage, followed by 27% at stage 2 and 5% at stage 3. Costs are being estimated by age, race/ethnicity, stage at diagnosis, and treatment protocol.

Learning Objectives: At the conclusion of the session, the participant will be able to

• identify the components of the costs of breast cancer
• discuss the economic impact of breast cancer for California women

Keywords: Breast Cancer, Economic Analysis

Presenting author's disclosure statement:

Any relevant financial relationships? No