Table 3.
Radiotherapy-related expenditures for breast cancer patients aged <65 yrs with commercial insurance plansa
| Type of costs | Radiotherapy Type |
Differences, U.S. $ b |
|
|---|---|---|---|
| CF-WBI | HF-WBI | ||
| Insurer paid [Mean, US $b] | |||
| 2008 | 19,167 | 15,654 | 3,513 |
| 2009 | 21,157 | 15,869 | 5,288 |
| 2010 | 21,498 | 17,136 | 4,362 |
| 2011 | 22,025 | 15,730 | 6,295 |
| 2012 | 22,517 | 15,948 | 6,569 |
| 2013 | 23,147 | 16,381 | 6,766 |
| 2014 | 23,286 | 17,311 | 5,975 |
| 2015 | 23,394 | 17,181 | 6,213 |
| 2016 | 24,603 | 18,352 | 6,251 |
| 2017 | 24,778 | 18,412 | 6,366 |
| Increment per year | 540 | 335 | |
|
| |||
| Patient OOP costs [Mean, US $b] | |||
| 2008 | 388 | 232 | 156 |
| 2009 | 439 | 262 | 177 |
| 2010 | 492 | 361 | 131 |
| 2011 | 502 | 318 | 184 |
| 2012 | 539 | 342 | 197 |
| 2013 | 559 | 388 | 170 |
| 2014 | 575 | 397 | 179 |
| 2015 | 523 | 412 | 111 |
| 2016 | 525 | 353 | 172 |
| 2017 | 437 | 362 | 75 |
| Increment per year | 13 | 9 | |
|
| |||
| a2008–2017 [Adjusted Mean (95% CI), US $b] | |||
| Total costs | 23,286 (23,158 to 23,415) |
16,763 (16,583 to 16,945) |
6,523 (6,294 to 6,751) |
| Insurer’s paid | 22,751 (22,623 to 22,880) |
16,376 (16,196 to 16,557) |
6,375 (6,147 to 6,603) |
| Patient OOP costs | 502 (491 to 513) |
363 (206 to 229) |
139 (119 to 160) |
Multivariable generalized linear models with Gamma distribution and log link, with the adjustment for year of radiotherapy, state of beneficiary health plan, age at the time of radiotherapy, type of breast cancer diagnosis, receipt of chemotherapy, Charlson comorbidity index, community education level (% in the community with a college degree or higher), and type of insurance plan. All the differences were statistically significant with p<0.0001.
All expenditures were rounded up to the nearest dollar amount in 2017 U.S. dollars after adjusting for inflation. CF-WBI: conventional fractionated whole breast irradiation therapy. HF-WBI: hypofractionated WBI. OOP: out of pocket. CI: confidence intervals.