(HealthDay News) — Breast cancer chemotherapy costs can vary by tens of thousands of dollars in the United States, depending on the course of treatment doctors select, according to a study published online Oct. 10 in Cancer.
Sharon Giordano, M.D., professor in breast medical oncology and chair of health services research at the University of Texas MD Anderson Cancer Center in Houston, and colleagues used mostly private insurance claims to calculate the cost of chemotherapy for 14,643 U.S. women diagnosed with breast cancer between 2008 and 2012. The analysis included all claims within 18 months of diagnosis. Costs were reflected in 2013 dollars and adjusted to account for a wide range of differences, including age at diagnosis, year of diagnosis, region of the country, and insurance plan type.
The researchers found that half of the insurers paid $82,260 for chemotherapy. Adding trastuzumab increased insurers’ median chemotherapy payment to $160,590. Compared with the most common treatment regimens, insurance costs varied by as much as $20,000 for women on non-trastuzumab regimens and $47,000 for women receiving the additional drug. Patients’ cost-sharing ranged from $2,724 to $3,381, on average, depending on whether or not they received trastuzumab-based therapies. However, one in 10 patients who did not receive trastuzumab paid out $7,041 for treatment. And one in 10 patients on trastuzumab-based therapies paid $8,384.
Swapping the three-drug regimen docetaxel, doxorubicin, and cyclophosphamide for dose-dense doxorubicin and cyclophosphamide, for example, could cut $15,000 in cost “without any evidence that one is better than the other,” Giordano told HealthDay. “If there are equal options, it does seem like we should consider, potentially, the cost.”
One author disclosed financial ties to Novartis, Roche, and Pfizer.