Sudewi Mukaromah Khoirunnisa, Didik Setiawan, Maarten J. Postma, Lisa A. de Jong
Introduction: Breast cancer is a leading cause of cancer-related disability-adjusted life years (DALYs) and the second most common cancer among Asian women, including in Indonesia. Its increasing burden necessitates a comprehensive assessment of epidemiological trends and economic impact. This study examines age- and severity-specific patterns of breast cancer incidence, DALYs, healthcare utilization, and economic burden in Indonesia from 2017 to 2020. Methods: A retrospective observational study was conducted using 2017–2020 National Health Insurance Sample Data (NHISD) from Indonesia's Health and Social Security Agency (BPJS Kesehatan). Breast cancer cases were identified using ICD-10 code C50. Incidence, DALYs, healthcare resource use, and economic burden were calculated annually by age and disease severity. Data were processed using R software version 4.2.3. Results: Incidence, mortality, and DALYs increased with age, particularly from age 35, peaking at 55–59 years, with DALYs highest among patients aged 45–60. Mortality and DALY peaks were observed in 2020 for ages 35–39 and 55–59. The economic burden rose significantly for women aged 50–54, from US$6 million in 2017 to US$13 million in 2019. Patients aged 35–39 incurred the highest annual per-patient costs (US$1410–US$1770). Outpatient costs dominated (US$17 million–US$23 million), with the most severe cases incurring per-patient costs of US$1150–US$1670. Conclusion: Despite a slight decline in incidence and relatively stable mortality, DALYs peaked in 2020, highlighting an increasing burden of disease. These trends underscore the need for targeted healthcare resource allocation and mitigation strategies, particularly for those aged 35–39, 45–60, and outpatient services. © 2025 The Author(s)
Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands; Department of Pharmacy, Institut Teknologi Sumatera, Lampung Selatan, Indonesia; Faculty of Pharmacy, Universitas Muhammadiyah Purwokerto, Banyumas, Indonesia; Centre for Health Economic Studies, Universitas Muhammadiyah Purwokerto, Banyumas, Indonesia; Department of Economics, Econometrics and Finance, Faculty of Economics & Business, University of Groningen, Groningen, Netherlands; Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Centre of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia