OBJECTIVES: To estimate the per-patient cost of hospital care associated with the treatment of breast cancer recurrence in the UK.
METHODS: Patient-level resource utilisation data for 571 node-positive early breast cancer patients treated at the Western general Hospital, Edinburgh between 1991 and 2004, of whom 180 experienced disease recurrence, were analysed in order to provide estimates of the cost of hospital care post-relapse. Unit costs from national sources were applied to patient-level resource use data for hospital care collected over a period of five years post-relapse. The total cost was estimated by bootstrapping (1000 simulations; with replacement).
RESULTS: Of the 180 patients who experienced a relapse, 145 (81%) died within follow-up, 143 of these due to breast cancer. The first relapse was distant in 145 patients and locoregional in 35 (25 of which experienced a subsequent distant disease, and 3 experienced further locoregional recurrence within follow-up). The bootstrap mean cost post-relapse (and 95% confidence intervals) was £14,085 (£12,370-£15,877) for patients whose first relapse was distant and £14,575 (£11,411 - £17,872) for patients whose first relapse was locoregional. Comparison with previous published estimates suggests that the cost of chemotherapy treatments has increased substantially in recent years.
CONCLUSIONS: Hospital costs for patients with relapsed breast cancer may be higher than previously estimated, perhaps due to recent increases in the costs of chemotherapy agents. Costs for patients whose first relapse is locoregional are similar on average to that for patients whose first relapse is distant, as many have subsequent locoregional or distant relapses.
