Healthcare costs associated with breast cancer in Germany: a claims data analysis

Kristine Kreis (), Marika Plöthner, Torben Schmidt, Richard Seufert, Katharina Schreeb, Veronika Jahndel, Sylke Maas, Alexander Kuhlmann, Jan Zeidler and Anja Schramm
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Kristine Kreis: Gottfried Wilhelm Leibniz Universität Hannover
Marika Plöthner: Gottfried Wilhelm Leibniz Universität Hannover
Torben Schmidt: Gottfried Wilhelm Leibniz Universität Hannover
Richard Seufert: AOK Bayern, Die Gesundheitskasse, DLZ Versorgungsmanagement
Katharina Schreeb: BioNTech AG
Veronika Jahndel: BioNTech AG
Sylke Maas: BioNTech AG
Alexander Kuhlmann: Gottfried Wilhelm Leibniz Universität Hannover
Jan Zeidler: Gottfried Wilhelm Leibniz Universität Hannover
Anja Schramm: AOK Bayern, Die Gesundheitskasse, DLZ Versorgungsmanagement

The European Journal of Health Economics, 2020, vol. 21, issue 3, No 11, 464 pages

Abstract: Abstract Purpose This study estimates the healthcare costs associated with breast cancer (BC) for different treatment phases (initial, intermediate, terminal) in Germany from the payer’s perspective. Methods The analysis uses claims data from the AOK Bayern covering 2011–2014 for continuously insured BC patients identified through inpatient and outpatient diagnoses. We calculate the healthcare costs attributable to BC using a control group design comparing the target population to a 1:2 matched control group adjusted for age, gender, and comorbidities. For incident and prevalent BC cases, we calculate age-standardized phase-specific incremental costs stratified by cost domain. Results The initial, intermediate, and terminal phases comprise 3841, 28,315, and 1767 BC cases, respectively. BC-related incremental costs follow a u-shaped curve, with costs highest near diagnosis and death, and lower in between. With average costs of €33,237 per incident and €28,211 per prevalent case in the remaining 11 months before death, the highest BC-related incremental healthcare costs can be found in the terminal phase. In the initial phase, there were mean incremental costs of €21,455 the first 11 months after diagnosis. In the intermediate phase, incremental costs totaled €2851 per incident and €2387 per prevalent case per year. Healthcare costs decreased with age in most phases. The cost drivers depend on the treatment phase, with cytostatic drugs and inpatient treatment showing the highest economic impact in most phases. Conclusion The study concludes that BC care costs impose a relevant economic burden on statutory health insurance and vary substantially depending on the treatment phase.

Keywords: Breast cancer; Disease cost; Claims data; Joinpoint; Germany (search for similar items in EconPapers)
JEL-codes: I10 I13 I14 (search for similar items in EconPapers)
Date: 2020
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DOI: 10.1007/s10198-019-01148-w

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