Despite being privately insured, patients receiving chemotherapy without trastuzumab for breast cancer may pay as much as $8000 in out-of-pocket costs, according to a study published in the journal Cancer.1

It is recommended that clinicians discuss costs of care with their patients, especially for patients with breast cancer who have several treatment options. It may be difficult, however, for clinicians to provide exact cost information. Researchers therefore determined cost estimates for breast cancer chemotherapy regimens from the perspectives of both payers and patients in a large, insured US population.

For the study, investigators analyzed data from 14,463 adult women who were diagnosed with breast cancer between 2008 and 2012. Patients also had no secondary malignancy within 1 year of diagnosis and received chemotherapy within 3 months of diagnosis.

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The median insurance payments were $160,590 among patients who received chemotherapy with trastuzumab and $8260 for those who had chemotherapy but not trastuzumab; median out-of-pocket payments were $3381 and $2724, respectively.

The researchers found that 25% of patients of patients who did not receive trastuzumab paid more than $4712 in out-of-pocket costs, while 10% paid more than $7041. Among those who received trastuzumab, 25% paid more than $5604 and 10% paid more than $8384.

Patients with high-deductible health insurance plans paid a median of $5158 in out-of-pocket costs; 25% paid more than $8128, and 10% paid at least $11344.

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This study is limited by its focus on a younger population with private health care insurance, and that those who lack insurance may endure substantially higher costs of care. Newer agents like pertuzumab were not included in this study and costs may decrease as generic agents become available.                           


  1. Gordano SH, Niu J, Chavez-MacGregor M, et al. Estimating regimen-specific costs of chemotherapy for breast cancer: Observational cohort study. Cancer. 2016 Oct 10. doi: 10.1002/cncr.30274 [Epub ahead of print]