Ekwueme Donatus U, Allaire Benjamin T, Guy Gery P, Arnold Sarah, Trogdon Justin G
Division of Cancer Prevention and Control, CDC, Atlanta, Georgia.
RTI International, Research Triangle Park, North Carolina;
Am J Prev Med. 2016 Feb;50(2):278-85. doi: 10.1016/j.amepre.2015.10.017.
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.
A sample of 5,542 younger women aged 19-44 years enrolled in fee-for-service Medicaid with diagnosis codes for breast cancer in 2007 were compared with 4.3 million women aged 19-44 years enrolled in fee-for-service Medicaid without breast cancer. Nonlinear regression methods estimated prevalent 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. Analyses were conducted in 2013 and all medical treatment costs were adjusted to 2012 U.S. dollars.
The estimated monthly direct medical costs for breast cancer treatment among younger women enrolled in Medicaid was $5,711 (95% CI=$5,039, $6,383) per woman. The estimated monthly cost for outpatient services was $4,058 (95% CI=$3,575, $4,541), for inpatient services was $1,003 (95% CI=$708, $1,298), and for prescription drugs was $539 (95% CI=$431, $647). By race/ethnicity, non-Hispanic white women had the highest monthly total medical costs, followed by Hispanic women and non-Hispanic women of other race.
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.
一些研究在州层面考察了医疗补助计划参保人群中乳腺癌治疗的成本。然而,尚无研究估算参加医疗补助计划的19至44岁女性在国家层面的乳腺癌治疗医疗成本。
选取了5542名参加按服务付费医疗补助计划且在2007年有乳腺癌诊断代码的19至44岁年轻女性样本,与430万参加按服务付费医疗补助计划且无乳腺癌的19至44岁女性进行比较。采用非线性回归方法估算患有乳腺癌的年轻女性与未患乳腺癌的年轻女性相比的普遍治疗成本。按种族/族裔和服务类型估算个人医疗成本。分析于2013年进行,所有医疗治疗成本均按2012年美元进行调整。
参加医疗补助计划的年轻女性中,乳腺癌治疗的估计每月直接医疗成本为每人5711美元(95%置信区间=5039美元,6383美元)。门诊服务的估计每月成本为4058美元(95%置信区间=3575美元,4541美元),住院服务为1003美元(95%置信区间=708美元,1298美元),处方药为539美元(95%置信区间=431美元,647美元)。按种族/族裔划分,非西班牙裔白人女性每月总医疗成本最高,其次是西班牙裔女性和其他种族的非西班牙裔女性。
成本估算表明,年轻的医疗补助计划受益人的乳腺癌治疗相关医疗成本巨大。随着医疗补助计划不断发展,这些治疗成本估算可作为该人群浸润性乳腺癌治疗规划决策的重要依据。