Breaking down the costs for breast cancer: Insights from Sweden's national quality register.

BACKGROUND: With new emerging technologies for diagnostics and treatment for breast cancer, there is a demand for updated breast cancer costs based on current clinical practice. The objectives of this study were to estimate recent societal costs of breast cancer in Sweden and provide population-based patient-level cost estimates for health economic evaluations. METHODS: This prevalence-based cost-of-illness study was based on 2019 data linking multiple Swedish national registers. The analysis employed a societal perspective considering direct health care, informal care, and productivity losses. Total costs were estimated using a bottom-up micro-costing approach. Direct costs per patient-year were also estimated by subgroups, including age group, breast cancer subtype, breast cancer stage at diagnosis, and disease state defined by metastatic status. FINDINGS: 82,960 breast cancer patients diagnosed since 2008 were alive by the end of 2019. The annual societal cost of breast cancer in Sweden was €632 million, where the direct health care, informal care, and productivity losses accounted for 37 %, 5 %, and 57 %, respectively. The cost per capita was €61. Costs of direct health care, including inpatient/outpatient care and prescribed drugs, varied by subgroups, where younger age, higher stage, and more adverse subtypes were associated with higher costs per patient-year. Patients with a diagnosis of de novo metastatic cancer incurred the highest mean cost per patient-year. CONCLUSION: Breast cancer represents a large economic burden in Sweden. The mean cost estimates per patient-year are informative to future health economic evaluations for breast cancer screening and treatment.