Direct Medical Costs, Productivity Loss Costs and Out-Of-Pocket Expenditures in Women with Breast Cancer in Latin America and the Caribbean: A Systematic Review

Alfredo Palacios; Carlos Rojas-Roque; Lucas González; Ariel Bardach; Agustín Ciapponi; Claudia Peckaitis; Andres Pichon-Riviere; Federico Augustovski

doi:10.1007/s40273-021-01014-9

Direct Medical Costs, Productivity Loss Costs and Out-Of-Pocket Expenditures in Women with Breast Cancer in Latin America and the Caribbean: A Systematic Review

Alfredo Palacios, Carlos Rojas-Roque, Lucas González, Ariel Bardach, Agustín Ciapponi, Claudia Peckaitis, Andres Pichon-Riviere, Federico Augustovski

Centre for Health Economics

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: Our objective was to conduct a systematic review of the literature to identify, categorise, assess, and synthesise the healthcare costs of patients with breast cancer (BC) and their relatives in Latin America and the Caribbean (LAC).

METHODS: In December 2020, we searched for published data in PubMed, LILACS, EMBASE, and other sources, including the grey literature. Studies were eligible if they were conducted in LAC and reported the direct medical costs, productivity loss costs, out-of-pocket expenditure, and other costs to patients with BC and their relatives. No restrictions were imposed on the type of BC population (metastatic BC or human epidermal growth factor receptor 2-positive/negative BC, among others). We summarised the characteristics and methodological approach of each study and the healthcare costs by cancer stage. We also developed and applied an original ad hoc instrument to assess the quality of the cost estimation studies.

RESULTS: We identified 2725 references and 63 included studies. In total, 79.3% of the studies solely reported direct medical costs and five solely reported costs to patients and their relatives. Only 14.3% of the studies were classified as of high quality. The pooled weighted average direct medical cost per patient-year (year 2020 international dollars [I$]) by BC stage was I$13,179 for stage I, I$15,556 for stage II, I$23,444 for stage III, and I$28,910 for stage IV.

CONCLUSION: This review provides the first synthesis of BC costs in LAC. Our findings show few high-quality costing studies in BC and a gap in the literature measuring costs to patients and their relatives. The high costs associated with the advanced stages of BC call into question the affordability of treatments and their accessibility for patients. Registered in PROSPERO (CRD42018106835).

Original language	English
Pages (from-to)	485-502
Number of pages	18
Journal	Pharmacoeconomics
Volume	39
Issue number	5
Early online date	30 Mar 2021
DOIs	https://doi.org/10.1007/s40273-021-01014-9
Publication status	Published - May 2021

Keywords

Breast Neoplasms/therapy
Caribbean Region
Efficiency
Female
Health Expenditures
Humans
Latin America

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10.1007/s40273-021-01014-9

Cite this

Palacios, A., Rojas-Roque, C., González, L., Bardach, A., Ciapponi, A., Peckaitis, C., Pichon-Riviere, A., & Augustovski, F. (2021). Direct Medical Costs, Productivity Loss Costs and Out-Of-Pocket Expenditures in Women with Breast Cancer in Latin America and the Caribbean: A Systematic Review. Pharmacoeconomics, 39(5), 485-502. https://doi.org/10.1007/s40273-021-01014-9

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title = "Direct Medical Costs, Productivity Loss Costs and Out-Of-Pocket Expenditures in Women with Breast Cancer in Latin America and the Caribbean: A Systematic Review",

abstract = "OBJECTIVE: Our objective was to conduct a systematic review of the literature to identify, categorise, assess, and synthesise the healthcare costs of patients with breast cancer (BC) and their relatives in Latin America and the Caribbean (LAC).METHODS: In December 2020, we searched for published data in PubMed, LILACS, EMBASE, and other sources, including the grey literature. Studies were eligible if they were conducted in LAC and reported the direct medical costs, productivity loss costs, out-of-pocket expenditure, and other costs to patients with BC and their relatives. No restrictions were imposed on the type of BC population (metastatic BC or human epidermal growth factor receptor 2-positive/negative BC, among others). We summarised the characteristics and methodological approach of each study and the healthcare costs by cancer stage. We also developed and applied an original ad hoc instrument to assess the quality of the cost estimation studies.RESULTS: We identified 2725 references and 63 included studies. In total, 79.3% of the studies solely reported direct medical costs and five solely reported costs to patients and their relatives. Only 14.3% of the studies were classified as of high quality. The pooled weighted average direct medical cost per patient-year (year 2020 international dollars [I$]) by BC stage was I$13,179 for stage I, I$15,556 for stage II, I$23,444 for stage III, and I$28,910 for stage IV.CONCLUSION: This review provides the first synthesis of BC costs in LAC. Our findings show few high-quality costing studies in BC and a gap in the literature measuring costs to patients and their relatives. The high costs associated with the advanced stages of BC call into question the affordability of treatments and their accessibility for patients. Registered in PROSPERO (CRD42018106835).",

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author = "Alfredo Palacios and Carlos Rojas-Roque and Lucas Gonz{\'a}lez and Ariel Bardach and Agust{\'i}n Ciapponi and Claudia Peckaitis and Andres Pichon-Riviere and Federico Augustovski",

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Palacios, A , Rojas-Roque, C, González, L, Bardach, A, Ciapponi, A, Peckaitis, C, Pichon-Riviere, A & Augustovski, F 2021, 'Direct Medical Costs, Productivity Loss Costs and Out-Of-Pocket Expenditures in Women with Breast Cancer in Latin America and the Caribbean: A Systematic Review', Pharmacoeconomics, vol. 39, no. 5, pp. 485-502. https://doi.org/10.1007/s40273-021-01014-9

TY - JOUR

T1 - Direct Medical Costs, Productivity Loss Costs and Out-Of-Pocket Expenditures in Women with Breast Cancer in Latin America and the Caribbean

T2 - A Systematic Review

AU - Palacios, Alfredo

AU - Rojas-Roque, Carlos

AU - González, Lucas

AU - Bardach, Ariel

AU - Ciapponi, Agustín

AU - Peckaitis, Claudia

AU - Pichon-Riviere, Andres

AU - Augustovski, Federico

PY - 2021/5

Y1 - 2021/5

N2 - OBJECTIVE: Our objective was to conduct a systematic review of the literature to identify, categorise, assess, and synthesise the healthcare costs of patients with breast cancer (BC) and their relatives in Latin America and the Caribbean (LAC).METHODS: In December 2020, we searched for published data in PubMed, LILACS, EMBASE, and other sources, including the grey literature. Studies were eligible if they were conducted in LAC and reported the direct medical costs, productivity loss costs, out-of-pocket expenditure, and other costs to patients with BC and their relatives. No restrictions were imposed on the type of BC population (metastatic BC or human epidermal growth factor receptor 2-positive/negative BC, among others). We summarised the characteristics and methodological approach of each study and the healthcare costs by cancer stage. We also developed and applied an original ad hoc instrument to assess the quality of the cost estimation studies.RESULTS: We identified 2725 references and 63 included studies. In total, 79.3% of the studies solely reported direct medical costs and five solely reported costs to patients and their relatives. Only 14.3% of the studies were classified as of high quality. The pooled weighted average direct medical cost per patient-year (year 2020 international dollars [I$]) by BC stage was I$13,179 for stage I, I$15,556 for stage II, I$23,444 for stage III, and I$28,910 for stage IV.CONCLUSION: This review provides the first synthesis of BC costs in LAC. Our findings show few high-quality costing studies in BC and a gap in the literature measuring costs to patients and their relatives. The high costs associated with the advanced stages of BC call into question the affordability of treatments and their accessibility for patients. Registered in PROSPERO (CRD42018106835).

AB - OBJECTIVE: Our objective was to conduct a systematic review of the literature to identify, categorise, assess, and synthesise the healthcare costs of patients with breast cancer (BC) and their relatives in Latin America and the Caribbean (LAC).METHODS: In December 2020, we searched for published data in PubMed, LILACS, EMBASE, and other sources, including the grey literature. Studies were eligible if they were conducted in LAC and reported the direct medical costs, productivity loss costs, out-of-pocket expenditure, and other costs to patients with BC and their relatives. No restrictions were imposed on the type of BC population (metastatic BC or human epidermal growth factor receptor 2-positive/negative BC, among others). We summarised the characteristics and methodological approach of each study and the healthcare costs by cancer stage. We also developed and applied an original ad hoc instrument to assess the quality of the cost estimation studies.RESULTS: We identified 2725 references and 63 included studies. In total, 79.3% of the studies solely reported direct medical costs and five solely reported costs to patients and their relatives. Only 14.3% of the studies were classified as of high quality. The pooled weighted average direct medical cost per patient-year (year 2020 international dollars [I$]) by BC stage was I$13,179 for stage I, I$15,556 for stage II, I$23,444 for stage III, and I$28,910 for stage IV.CONCLUSION: This review provides the first synthesis of BC costs in LAC. Our findings show few high-quality costing studies in BC and a gap in the literature measuring costs to patients and their relatives. The high costs associated with the advanced stages of BC call into question the affordability of treatments and their accessibility for patients. Registered in PROSPERO (CRD42018106835).

KW - Breast Neoplasms/therapy

KW - Caribbean Region

KW - Efficiency

KW - Female

KW - Health Expenditures

KW - Humans

KW - Latin America

U2 - 10.1007/s40273-021-01014-9

DO - 10.1007/s40273-021-01014-9

M3 - Article

C2 - 33782865

SN - 1170-7690

VL - 39

SP - 485

EP - 502

JO - Pharmacoeconomics

JF - Pharmacoeconomics

IS - 5

ER -