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Science Friday
Breast cancer costs poor people more
Low-income groups’ relative out-of-pocket costs far exceed those paid by wealthy patients
Web edition : Saturday, December 13th, 2008
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SAN ANTONIO — As a percentage of family income, money spent by U.S. women with breast cancer is much greater for low-income patients than for those who are well off, according to research presented December 12 in Texas at the San Antonio Breast Cancer Symposium.

Public health researcher Lisa Lines of the consulting firm Boston Health Economics in Waltham, Mass., and her colleagues analyzed expenditures made by 806 breast cancer patients from 1996 to 2005. Out-of-pocket costs included insurance premiums, payments to meet deductibles, co-pays and any other payments made to meet medical or drug costs associated with treatment.

The average annual out-of-pocket expenditure was about $2,300 per breast cancer patient, about half of which was spent on prescription drugs.

“Breast cancer is actually not the most expensive cancer for out-of-pocket expenditures,” Lines says. This and other data suggest that breast cancer costs patients more than colon or prostate cancer, but less than lung cancer, she says.

But breast cancer has a large proportion of people with a “high burden,” she says. The researchers classified patients as having a high burden when their out-of-pocket costs for coping with the cancer exceeded 10 percent of the family’s income. Roughly 70 percent of low-income breast cancer patients fell into the high-burden category in this analysis, compared with about 15 percent of middle-income and less than 5 percent of high-income breast cancer patients — apparently the result of better insurance, she says.

Cancer patients in general are disproportionately affected by a high out-of-pocket burden. That’s because many cancers have come to be treated more like a chronic disease than they used to be and are treated on an outpatient basis, Lines says. In the past, most cancer patients were treated in hospitals, where major medical insurance covered much of the cost.


Found in: Body & Brain and Science & Society
Comments 1
  • This is a rather unsurprising result. For any fixed price item, low income people pay higher precentage of their income than high income people. The insured's portion of medical costs are either a fixed amount or a percentage of the cost, not a percentage of the insured's income, so low income people obviously pay a higher proportion of income on medical costs. They also tend to spend a higher proportion on food and housing.
    Thomas Wicklund Thomas Wicklund
    Dec. 14, 2008 at 12:58pm
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Suggested Reading:
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  • Lloyd KG et al. Out-Of-Pocket Costs and Lost Wages Associated with Colorectal, Breast, and Prostate Cancer Care. 2001. Proceedings of the American Society of Clinical Oncology, Abstract # 961.
Citations & References:
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  • Lines LM et al. Out-of-pocket costs among women with breast cancer: data from the medical expenditure panel survey 1996-2005.
    AACR–San Antonio Breast Cancer Symposium, 2008.
    Abstract # 3111
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