Patterns of care and cost profiles of women with breast cancer in Italy: EPICOST study based on real world data

Silvia Francisci, Stefano Guzzinati, Giulia Capodaglio, Daniela Pierannunzio, Sandra Mallone, Andrea Tavilla, Tania Lopez, Susanna Busco, Walter Mazzucco, Catia Angiolini, Manuel Zorzi, Diego Serraino, Alessandro Barchielli, Mario Fusco, Fabrizio Stracci, Fortunato Bianconi, Massimo Rugge, Silvia Iacovacci, Antonio Giampiero Russo, Rosanna CusimanoAnna Gigli

Research output: Contribution to journalArticlepeer-review


Objectives: To estimate total direct health care costs associated to diagnosis and treatment of women with breast cancer in Italy, and to investigate their distribution by service type according to the disease pathway and patient characteristics. Methods: Data on patients provided by population-based Cancer Registries are linked at individual level with data on health-care services and corresponding claims from administrative databases. A combination of cross-sectional approach and a threephase of care decomposition model with initial, continuing and final phases-of-care defined according to time occurred since diagnosis and disease outcome is adopted. Direct estimation of cancer-related costs is obtained. Results: Study cohort included 49,272 patients, 15.2% were in the initial phase absorbing 42% of resources, 79.7% in the continuing phase absorbing 44% of resources and 5.1% in the final phase absorbing 14% of resources. Hospitalization was the most important cost driver, accounting for over 55% of the total costs. Conclusions: This paper represents the first attempt in Italy to estimate the economic burden of cancer at population level taking into account the entire disease pathway and using multiple current health care databases. The evidence produced by the study can be used to better plan resources allocation. The model proposed is replicable to countries with individual health care information on services and claims.

Original languageEnglish
Pages (from-to)1003-1013
Number of pages11
JournalEuropean Journal of Health Economics
Issue number7
Publication statusPublished - Sep 1 2020


  • Administrative data
  • Breast cancer
  • Cost analysis
  • Health care utilization
  • Real world data

ASJC Scopus subject areas

  • Economics, Econometrics and Finance (miscellaneous)
  • Health Policy


Dive into the research topics of 'Patterns of care and cost profiles of women with breast cancer in Italy: EPICOST study based on real world data'. Together they form a unique fingerprint.

Cite this