Patient co-payments for women diagnosed with breast cancer in Australia

Bates, Nicole, Callander, Emily, Lindsay, Daniel, and Watt, Kerrianne (2019) Patient co-payments for women diagnosed with breast cancer in Australia. Supportive Care in Cancer. (In Press)

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Among Australian women, breast cancer is the most commonly diagnosed cancer. The out-of-pocket cost to the patient is substantial. This study estimates the total patient co-payments for Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) for women diagnosed with breast cancer and determined the distribution of these costs by Indigenous status, remoteness, and socioeconomic status.

Methods Data on women diagnosed with breast cancer in Queensland between 01 July 2011 and 30 June 2012 were obtained from the Queensland Cancer Registry and linked with hospital and Emergency Department Admissions, and MBS and PBS records for the 3 years post-diagnosis. The data were then weighted to be representative of the Australian population. The co-payment charged for MBS services and PBS prescriptions was summed. We modelled the mean co-payment per patient during each 6-month time period for MBS services and PBS prescriptions.


A total of 3079 women were diagnosed with breast cancer in Queensland during the 12-month study period, representing 15,335 Australian women after weighting. In the first 3 years post-diagnosis, the median co-payment for MBS services was AU$ 748 (IQR, AU$87–2121; maximum AU$32,249), and for PBS prescriptions was AU$ 835 (IQR, AU$480–1289; maximum AU$5390). There were significant differences in the co-payments for MBS services and PBS prescriptions by Indigenous status and socioeconomic disadvantage, but none for remoteness.


Women incur high patient co-payments in the first 3 years post-diagnosis. These costs vary greatly by patient. Potential costs should be discussed with women throughout their treatment, to allow women greater choice in the most appropriate care for their situation.

Item ID: 59936
Item Type: Article (Research - C1)
ISSN: 1433-7339
Keywords: breast cancer; patient co-payment; financial toxicity; Australia
Copyright Information: © The Author(s) 2019. Open Access: this article is distributed under the terms of the Creative Commons Attribution 4.0 International License.
Funders: Australian Government Research Training Program Scholarship
Date Deposited: 04 Sep 2019 00:27
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1112 Oncology and Carcinogenesis > 111299 Oncology and Carcinogenesis not elsewhere classified @ 40%
14 ECONOMICS > 1402 Applied Economics > 140208 Health Economics @ 60%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920102 Cancer and Related Disorders @ 60%
91 ECONOMIC FRAMEWORK > 9199 Other Economic Framework > 919999 Economic Framework not elsewhere classified @ 40%
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