DIRECT MEDICAL COSTS OF BREAST CANCER BY SUBTYPE AND STAGE IN KOREA: A PATIENT-LEVEL RETROSPECTIVE COHORT ANALYSIS
Author(s)
Daewon Kang, PharmD, PhD1, Eunmi Bae, BS2, Sang-Eun Choi, MPH, PhD3.
1PhD, Korea University, Sejong city, Korea, Republic of, 2Korea University, Sejong city, Korea, Republic of, 3Korea University, Sejong, Korea, Republic of.
1PhD, Korea University, Sejong city, Korea, Republic of, 2Korea University, Sejong city, Korea, Republic of, 3Korea University, Sejong, Korea, Republic of.
OBJECTIVES: This study sought to quantify medical expenditures among Korean patients with breast cancer, stratified by molecular subtype and stage of disease progression.
METHODS: In this retrospective cohort analysis, we estimated 5-year medical costs for 13,797 breast cancer patients using the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE), which integrates national health insurance claims with cancer registry data from 2007 to 2019. Costs were analyzed according to molecular subtype and disease stage. Generalized estimating equations (GEE) were applied to assess the effects of clinical and demographic factors on healthcare expenditures. In addition, compound annual growth rates were calculated to evaluate temporal trends in costs across major treatment components, including surgery, radiotherapy, adjuvant chemotherapy, and targeted therapies.
RESULTS: Breast cancer-related expenditures were highest during the first year following diagnosis and decreased substantially thereafter. By molecular subtype, the highest first-year costs were observed in HR−/HER2+ patients (USD 22,408), followed by HR+/HER2+ (USD 21,765), HR−/HER2− (USD 16,699), and HR+/HER2− (USD 14,251). GEE analyses demonstrated that annual medical costs varied significantly by subtype. Compared with early-stage disease, advanced-stage breast cancer was associated with a 43-56% increase in annual costs. Costs were also notably higher in cases of distant recurrence (39-61% increase) and during the terminal phase of care (46-112% increase). Expenditures for adjuvant chemotherapy rose annually by 8.57%. Costs associated with distant recurrence remained persistently elevated through the second and third years post-recurrence, regardless of subtype.
CONCLUSIONS: Direct medical costs for breast cancer in Korea have risen considerably, particularly among patients with HER2-positive tumors and advanced-stage disease. These subtype-stratified costs can support future assessments of cost-effectiveness and guide resource allocation within national healthcare programs.
METHODS: In this retrospective cohort analysis, we estimated 5-year medical costs for 13,797 breast cancer patients using the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE), which integrates national health insurance claims with cancer registry data from 2007 to 2019. Costs were analyzed according to molecular subtype and disease stage. Generalized estimating equations (GEE) were applied to assess the effects of clinical and demographic factors on healthcare expenditures. In addition, compound annual growth rates were calculated to evaluate temporal trends in costs across major treatment components, including surgery, radiotherapy, adjuvant chemotherapy, and targeted therapies.
RESULTS: Breast cancer-related expenditures were highest during the first year following diagnosis and decreased substantially thereafter. By molecular subtype, the highest first-year costs were observed in HR−/HER2+ patients (USD 22,408), followed by HR+/HER2+ (USD 21,765), HR−/HER2− (USD 16,699), and HR+/HER2− (USD 14,251). GEE analyses demonstrated that annual medical costs varied significantly by subtype. Compared with early-stage disease, advanced-stage breast cancer was associated with a 43-56% increase in annual costs. Costs were also notably higher in cases of distant recurrence (39-61% increase) and during the terminal phase of care (46-112% increase). Expenditures for adjuvant chemotherapy rose annually by 8.57%. Costs associated with distant recurrence remained persistently elevated through the second and third years post-recurrence, regardless of subtype.
CONCLUSIONS: Direct medical costs for breast cancer in Korea have risen considerably, particularly among patients with HER2-positive tumors and advanced-stage disease. These subtype-stratified costs can support future assessments of cost-effectiveness and guide resource allocation within national healthcare programs.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
MSR83
Topic
Economic Evaluation, Methodological & Statistical Research, Real World Data & Information Systems
Disease
Oncology