Direct and indirect costs of breast cancer management in Sub-Saharan Africa

In Benin, breast cancer is the leading cause of cancer-related mortality among women, with 566 deaths reported in 2020. The cost of its management remains poorly understood, although its estimation is essential for assessing the implementation of public health policies, particularly in a resource-limited setting. This study aims to estimate the direct and indirect costs of breast cancer management from the patients' perspective.

This cross-sectional study was conducted in three healthcare facilities in Cotonou, collecting healthcare expenditures from 104 breast cancer patients through a structured questionnaire. A linear regression analysis was performed to identify factors influencing direct medical costs.

The average direct medical cost of breast cancer management in Benin was estimated at US$ 4768.3 (± US$ 774.7). The median productivity loss cost, based on patient-reported data, was US$ 954.4 (IQR = US$ 477.2 - US$ 1336.1). Chemotherapy accounted for 38.5 % of the direct medical costs. An advanced disease stage was significantly associated with higher medical costs (coefficient = 0.50; p = 0.007).

Breast cancer leads to high direct and indirect costs, especially in the advanced stages of the disease in Sub-Saharan Africa. These findings highlight the need for the implementation of early screening programs to reduce costs.