ArticleBreast cancer research and treatment2018
Total and out-of-pocket expenditures among women with metastatic breast cancer in low-deductible versus high-deductible health plans.
Article in Breast cancer research and treatment, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Out-of-Pocket Cost Burden of Cancer Care-A Systematic Literature Review.Current oncology (Toronto, Ont.) · 2021Pooled it
- The LIFT UP study: feasibility of systematically identifying and addressing resource needs in those with metastatic breast cancer.Breast cancer research and treatment · 2026Article
- "It's just not easy to understand": A mixed methods study of health insurance literacy and insurance plan decision-making in cancer survivors.Cancer medicine · 2023Article
- Multidimensional financial hardship among uninsured and insured young adult patients with metastatic breast cancer.Cancer medicine · 2023Article
- Costs Around the First Year of Diagnosis for 4 Common Cancers Among the Privately Insured.Journal of the National Cancer Institute · 2022Article
- Association of High-Deductible Health Plan Enrollment With Spending on and Use of Lenalidomide Therapy Among Commercially Insured Patients With Multiple Myeloma.JAMA network open · 2022Article
- Out-of-Pocket Costs Among Patients With a New Cancer Diagnosis Enrolled in High-Deductible Health Plans vs Traditional Insurance.JAMA network open · 2021Article
- Financial Toxicity of Cancer Care: An Analysis of Financial Burden in Three Distinct Health Care Systems.JCO oncology practice · 2021Article
- Nonelderly Adult Cancer Survivors in High Deductible Health Plan: Healthcare Expenditure, Utilization and Access.Healthcare (Basel, Switzerland) · 2021Article
- Effects of cancer treatment on household impoverishment: a multicentre cross-sectional study in China.BMJ open · 2021Article
- Using a Twitter Chat to Rapidly Identify Barriers and Policy Solutions for Metastatic Breast Cancer Care: Qualitative Study.JMIR public health and surveillance · 2021Article
- Trends in screening breast magnetic resonance imaging use among US women, 2006 to 2016.Cancer · 2020Observational
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
purposeHigh-deductible health plan (HDHP) enrollment is expanding rapidly and might substantially increase out-of-pocket (OOP) payment burden. We examined trends in total and OOP health service expenditures overall and by insurance coverage type among women with metastatic breast cancer.
methodsWe used a longitudinal time series design to examine measures among 5364 women with metastatic breast cancer insured by a large US health insurer from 2004 to 2011. We measured outcomes during the 12 months after a first identified metastatic breast cancer diagnosis and required women to have at least 6 months of prior enrollment. We plotted enrollment measures and adjusted total and OOP spending. We fit trend lines using linear autoregressive models.
resultsBetween 2004 and 2011, the percentage of women with metastatic breast cancer enrolled in employer-mandated HDHPs increased from 8 to 23% while the percentage enrolled in employer-mandated low-deductible plans (LDHPs) decreased from 69 to 37%. Over the same time period, estimated annual inflation-adjusted total health service spending among women with metastatic breast cancer whose employers only offered HDHPs or LDHPS increased from $96,899 to $104,688 (increase of $1197 per year; 95% confidence interval [CI]: $47,$2,348). Corresponding OOP spending values among these women with employer-mandated deductible levels were $4,496 and $5,151 ($91 per year trend; 95% CI -$13,$195). From 2004-2011, women in HDHPs and LDHPs had unchanged annual OOP spending, estimated at of $6642 (95% CI $6,268,$7016) and $4,247 (95% CI $3956,$4538), respectively. Thus, women in HDHPs experienced 55% (44%, 66%) more OOP spending than women in LDHP.
conclusionsOOP spending among women with metastatic breast cancer and employer-mandated deductible levels was 55% higher among HDHP than LDHP members, and employer-mandated HDHP enrollment increased substantially from 2004 to 2011. Stakeholders and policymakers should design health plans that protect financially vulnerable cancer patients from high OOP costs.
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