OBJECTIVES: Breast cancer is the second most common cancer among women in the US. The objectives of this study were to conduct a systematic review of recent publications that evaluated the costs of care of women with breast cancer in active treatment and stratify the costs by payer type.

METHODS: A systematic review of PubMed from January 2010 to December 2016 was conducted to identify relevant publications. The initially identified abstracts were reviewed to select full text manuscripts containing details of breast cancer costs and cost estimating methodology. From the identified publications, cost data were extracted and reviewed by 2 independent researchers. The extracted data contained breast cancer related cost information during active cancer treatment among women with specific payer types. All retrieved cost data were inflation adjusted to 2016 USD.

RESULTS: Of the studies included (n=15), 4 were from a commercial payer perspective, 8 were from a Medicare perspective (4 evaluated radiation therapy cost only), and 3 were from a Medicaid perspective. For commercial payers and Medicare, breast cancer related care costs during 12 months of active treatment averaged $61,420 per patient (standard deviation (SD): $7,166, median: $58,648) and $28,906 per patient (SD: $6,741, median: $27,760), respectively. Costs for outpatient care ($39,905 per patient, SD: $14,195, median: $38,448) contributed most to the overall costs of breast cancer related care for commercially-insured patients. Outpatient care was inconsistently defined across studies of Medicare-insured women, but reported radiation therapy costs averaged $12,482 per patient (SD: $4,444, median: $11,347). Cost data for breast cancer related care among Medicaid beneficiaries is limited.

CONCLUSIONS: The cost of breast cancer related care varies across payer types, with commercial payers having the greatest burden per patient in the US. For more reliable cost estimates, especially from the perspective of Medicaid, further study is warranted.