VP, Biostatistics Ontada Chestnut Hill, United States
Background: Breast cancer is the most common malignancy among women in the US. Early diagnosis of breast cancer is associated with better clinical outcomes. However, the costs of care in a community oncology setting over time has not been thoroughly examined.
Objectives: To evaluate outpatient cost of care and changes in cost over time among patients with breast cancer treated in a large network of US community oncology clinics.
Methods: The analysis included women diagnosed with breast cancer in the US Oncology Network from January 2015 through December 2022. Data were sourced from iKnowMed™ (iKM), an oncology-specific electronic health record system that captures outpatient practice encounter histories as well as demographics and clinical information for nearly 40% of US community oncology practices. iKM records are deterministically linked to claims and remittance data, which have paid amount. All costs were standardized to 2022 US dollars ($) and analyzed descriptively as cost per patient per month (PPPM) longitudinally since 2015.
Results: The study included an eligible subset of 48,221 patients across all 4 US census divisions. The median (Q1, Q3) age was 61 (51, 70), 67% were white, and 5% were treated in rural areas. The payer type distribution for this study cohort was 59% commercial, and 41% Medicare/Medicaid. The median (Q1, Q3; same below) total outpatient medical care cost was $1.2k (0.4k, 3.3k) PPPM where 1k=1000. More advanced disease was associated with higher PPPM costs, ranging from $0.8k (0.3k, 2.3k) for patients diagnosed with stage I to $2.5k (0.9k, 6.7k) for patients diagnosed with stage IV. There was a significant increase in costs over the past 5 years, from $0.9k (0.4k, 2.3k) in 2015 to $2.8k (1.0k, 8.2k) in 2022 (p < 0.001).
Conclusions: This retrospective study of patients with breast cancer assessed the cost of care in community oncology settings in the US and showed that the cost of treating breast cancer has increased over time. Results may provide oncology stakeholders with insights into how advancements in breast cancer care influences rising costs.
