OBJECTIVES: Endometrial cancer (EC) is associated with substantial healthcare costs on a global scale; however, cost data from low- and middle-income countries are limited. Here, we describe healthcare costs borne by the health system and incurred by patients with EC affiliated with the contributory regime in Colombia.

METHODS: We retrospectively identified a cohort of incident patients with EC from patient-level data in national administrative databases. Included patients were required to have a first recorded EC diagnosis between 1 January 2014–31 December 2015 (index). Healthcare costs incurred by patients from index to either death or 31 December 2019 were assessed. We used Kaplan-Meier sample-average estimators with monthly intervals to adjust for differences in survival and duration of follow-up. All costs are annual and shown using survival-adjusted medians with interquartile ranges (IQR) and are reported in 2019 international dollars. To identify characteristics associated with higher care costs, we used generalized linear models, with a squared-root link function and a Poisson distribution.

RESULTS: In total, 833 patients with EC (mean age [standard deviation] 59.4 [12.5] years) were identified. The median costs of healthcare services were $9,101 (IQR $8,920 to $9,229), ranging from $7,941 (IQR $7,281 to $8,396) during the first year to $304 (IQR $285 to $322) the fifth year following diagnosis. Most of the costs were related to outpatient (63.5%), and inpatient (33.2%), distributed respectively on consultations (7.2%, 0.3%), medications (33.4%, 7.5%), and procedures (59.5%, 92.2%). We found that an older age at diagnosis, a higher comorbidity burden, and a higher proportion of services paid under fee for services schemes were associated with increased healthcare costs.

CONCLUSIONS: EC is associated with substantial healthcare costs in the population affiliated with the contributory regime in Colombia. Besides clinical and demographic characteristics, how providers are paid remains a strong predictor of healthcare costs in EC.