Costs of Early Invasive Breast Cancer in England Using National Patient-Level Data

Li Sun; David Cromwell; David Dodwell; Kieran Horgan; Melissa Ruth Gannon; Jibby Medina; Mark Pennington; Rosa Legood; Isabel dos-Santos-Silva; Zia Sadique

doi:10.1016/j.jval.2020.05.013

Costs of Early Invasive Breast Cancer in England Using National Patient-Level Data

Li Sun^*, David Cromwell, David Dodwell, Kieran Horgan, Melissa Ruth Gannon, Jibby Medina, Mark Pennington, Rosa Legood, Isabel dos-Santos-Silva, Zia Sadique

^*Corresponding author for this work

Health Service & Population Research

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

Abstract

Objectives: This study aimed to use patient-level data to provide up-to-date estimates of early invasive breast cancer care costs by stage in England and to explore to what extent these costs varied based on patients’ ages and geographic regions. Methods: This study identified women aged 50 years and older who had been diagnosed with early invasive breast cancer between January 1, 2014, and December 31, 2015, using linked cancer registrations and routine hospital data sets generated from the usual care for all National Health Service trusts in England. Cost estimates were derived from hospital records in Hospital Episodes Statistics with additional chemotherapy and radiotherapy information from the national data sets. We fitted general linear regression models to analyze the cost data. The model that best fit the data was selected using the model selection criteria of Akaike information criterion. Results: 55 662 women with early invasive breast cancer in England were included. The generalized linear model with log-gamma distribution fit the data best. The costs of breast cancer care for 1 year after diagnosis were strongly dependent on stage at diagnosis, controlling for other covariates. The estimated average per-patient hospital-related costs were £5167 at stage I, £7613 at stage II, and £13 330 at stage IIIA. Costs decreased with increasing age (P <.001) and varied across region (P <.001), deprivation level (P <.001), referral source (P <.01), presence of comorbidities (P<.001), and tumor receptor (ER/PR/HER2) status (P <.001). Conclusions: In England, the costs of breast cancer care increased with advancing stage of the disease at diagnosis. Breast cancer costs varied by age and geographic region.

Original language	English
Pages (from-to)	1316-1323
Number of pages	8
Journal	Value in Health
Volume	23
Issue number	10
DOIs	https://doi.org/10.1016/j.jval.2020.05.013
Publication status	Published - Oct 2020

Keywords

breast cancer
costs
patient-level data
stage at diagnosis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jval.2020.05.013

Cite this

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title = "Costs of Early Invasive Breast Cancer in England Using National Patient-Level Data",

abstract = "Objectives: This study aimed to use patient-level data to provide up-to-date estimates of early invasive breast cancer care costs by stage in England and to explore to what extent these costs varied based on patients{\textquoteright} ages and geographic regions. Methods: This study identified women aged 50 years and older who had been diagnosed with early invasive breast cancer between January 1, 2014, and December 31, 2015, using linked cancer registrations and routine hospital data sets generated from the usual care for all National Health Service trusts in England. Cost estimates were derived from hospital records in Hospital Episodes Statistics with additional chemotherapy and radiotherapy information from the national data sets. We fitted general linear regression models to analyze the cost data. The model that best fit the data was selected using the model selection criteria of Akaike information criterion. Results: 55 662 women with early invasive breast cancer in England were included. The generalized linear model with log-gamma distribution fit the data best. The costs of breast cancer care for 1 year after diagnosis were strongly dependent on stage at diagnosis, controlling for other covariates. The estimated average per-patient hospital-related costs were £5167 at stage I, £7613 at stage II, and £13 330 at stage IIIA. Costs decreased with increasing age (P <.001) and varied across region (P <.001), deprivation level (P <.001), referral source (P <.01), presence of comorbidities (P<.001), and tumor receptor (ER/PR/HER2) status (P <.001). Conclusions: In England, the costs of breast cancer care increased with advancing stage of the disease at diagnosis. Breast cancer costs varied by age and geographic region.",

keywords = "breast cancer, costs, patient-level data, stage at diagnosis",

author = "Li Sun and David Cromwell and David Dodwell and Kieran Horgan and Gannon, {Melissa Ruth} and Jibby Medina and Mark Pennington and Rosa Legood and Isabel dos-Santos-Silva and Zia Sadique",

year = "2020",

month = oct,

doi = "10.1016/j.jval.2020.05.013",

language = "English",

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pages = "1316--1323",

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}

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T1 - Costs of Early Invasive Breast Cancer in England Using National Patient-Level Data

AU - Sun, Li

AU - Cromwell, David

AU - Dodwell, David

AU - Horgan, Kieran

AU - Gannon, Melissa Ruth

AU - Medina, Jibby

AU - Pennington, Mark

AU - Legood, Rosa

AU - dos-Santos-Silva, Isabel

AU - Sadique, Zia

PY - 2020/10

Y1 - 2020/10

N2 - Objectives: This study aimed to use patient-level data to provide up-to-date estimates of early invasive breast cancer care costs by stage in England and to explore to what extent these costs varied based on patients’ ages and geographic regions. Methods: This study identified women aged 50 years and older who had been diagnosed with early invasive breast cancer between January 1, 2014, and December 31, 2015, using linked cancer registrations and routine hospital data sets generated from the usual care for all National Health Service trusts in England. Cost estimates were derived from hospital records in Hospital Episodes Statistics with additional chemotherapy and radiotherapy information from the national data sets. We fitted general linear regression models to analyze the cost data. The model that best fit the data was selected using the model selection criteria of Akaike information criterion. Results: 55 662 women with early invasive breast cancer in England were included. The generalized linear model with log-gamma distribution fit the data best. The costs of breast cancer care for 1 year after diagnosis were strongly dependent on stage at diagnosis, controlling for other covariates. The estimated average per-patient hospital-related costs were £5167 at stage I, £7613 at stage II, and £13 330 at stage IIIA. Costs decreased with increasing age (P <.001) and varied across region (P <.001), deprivation level (P <.001), referral source (P <.01), presence of comorbidities (P<.001), and tumor receptor (ER/PR/HER2) status (P <.001). Conclusions: In England, the costs of breast cancer care increased with advancing stage of the disease at diagnosis. Breast cancer costs varied by age and geographic region.

AB - Objectives: This study aimed to use patient-level data to provide up-to-date estimates of early invasive breast cancer care costs by stage in England and to explore to what extent these costs varied based on patients’ ages and geographic regions. Methods: This study identified women aged 50 years and older who had been diagnosed with early invasive breast cancer between January 1, 2014, and December 31, 2015, using linked cancer registrations and routine hospital data sets generated from the usual care for all National Health Service trusts in England. Cost estimates were derived from hospital records in Hospital Episodes Statistics with additional chemotherapy and radiotherapy information from the national data sets. We fitted general linear regression models to analyze the cost data. The model that best fit the data was selected using the model selection criteria of Akaike information criterion. Results: 55 662 women with early invasive breast cancer in England were included. The generalized linear model with log-gamma distribution fit the data best. The costs of breast cancer care for 1 year after diagnosis were strongly dependent on stage at diagnosis, controlling for other covariates. The estimated average per-patient hospital-related costs were £5167 at stage I, £7613 at stage II, and £13 330 at stage IIIA. Costs decreased with increasing age (P <.001) and varied across region (P <.001), deprivation level (P <.001), referral source (P <.01), presence of comorbidities (P<.001), and tumor receptor (ER/PR/HER2) status (P <.001). Conclusions: In England, the costs of breast cancer care increased with advancing stage of the disease at diagnosis. Breast cancer costs varied by age and geographic region.

KW - breast cancer

KW - costs

KW - patient-level data

KW - stage at diagnosis

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DO - 10.1016/j.jval.2020.05.013

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SN - 1098-3015

VL - 23

SP - 1316

EP - 1323

JO - Value in Health

JF - Value in Health

IS - 10

ER -

Costs of Early Invasive Breast Cancer in England Using National Patient-Level Data

Abstract

Keywords

UN SDGs

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