OBJECTIVES:

No local cost studies have been conducted in Chile to estimate medium costs of breast-cancer (BC) biopsies in the public sector. In a local context of increased demand, it is urgent to elucidate the impact of this activity in public laboratories, considering relevant cost drivers.

METHODS:

We conducted a Time-Driven Activity-Based Costing (TDABC) in a public laboratory responsible for processing 8.8% of national BC intraoperative biopsies (IB). A comprehensive Business Process Management Notation diagram was constructed to represent activities and processing times. Biopsies were broken into pre-analytic, analytic, and post-analytic stages. We considered these biopsy types: IB, Hematoxylin and Eosin staining (H&E), and Immunohistochemical study (IS). Direct (human resources (HR), equipment, and supplies) and Indirect costs were estimated. Turn-Around Time (TAT) was calculated.

RESULTS:

All biopsies ranked in a similar indirect versus direct cost distribution; however, direct costs varied per type. IB resulted in a medium cost of USD$27.01 -per biopsy- at an indirect cost of USD$4.36 (16.1%) and a direct cost of USD$22.66. Out of medium cost per IB, equipment explains 39.4%, HR 37.4%, and supplies 7.0%. IB showed a TAT of 0.6 hours. H&E resulted in a medium cost of USD$55.57, for which indirect cost (23.1% equal to USD$14.48) and HR in direct costs (68.3% equivalent to USD$37.95) were the most impactful costs drivers. Its TAT was 36.91 hours. For IS a total cost of USD$122.46 was calculated, at a total direct cost of USD$89.93 (73.4%), out of which supplies explain 38.1% of total cost. A TAT was calculated in 6.98 hours.

CONCLUSIONS:

This became the first TDABC study in Chile in BC biopsies in the public sector. Biopsy costs varied per type and by cost driver. Particular attention should be paid to innovation in adopting new technologies to accelerate processing times and workflow due to its impact.