Disease Burden and Cost of Illness of Female Breast Cancer in Poland: A Societal-Perspective Analysis with Cost Attribution to Payers, Patients, and the Economy

Background/Objectives: No Polish study has combined breast-cancer disease burden with a societal cost of illness attributing costs to their bearers. We estimated disease burden in disability-adjusted life years (DALYs), societal cost of illness, and its distribution across payers, patients, and the economy. Methods: Secondary modelling cost-of-illness analysis of administrative, registry, and public-statistical data (NFZ, ZUS, GUS, NCR) and GBD 2023. Productivity losses used a human-capital approach. Two tiers are reported: a core estimate from administrative and registry sources, and an exploratory extended scenario adding patient-reported components extrapolated nationally from a non-probability sample of 289 women (non-validated questionnaire). Deterministic and probabilistic sensitivity analyses were performed; 95% intervals are model-based simulation intervals. Reference year 2024; mortality 2023. Results: In 2023, breast cancer caused 151,355 DALYs (138,492 YLLs, 12,863 YLDs), 91.5% from premature mortality. The core societal cost was approximately EUR 1.41 billion (EUR 1.34–1.49 billion); NFZ expenditure was EUR 837.7 million. Adding patient-reported costs and time losses, the extended scenario reached EUR 4.54 billion (EUR 3.81–5.40 billion); as its largest components are derived from the convenience sample, it is exploratory, not a national estimate. Indirect costs dominated it; direct medical costs led the core estimate. The public payer bore 18.5% of the extended total, patients/households 41.2%, employers 40.3%. Conclusions: The burden is driven predominantly by premature mortality and productivity loss. Policy inferences should rest on the core estimate; the extended figure is exploratory. Analyses restricted to healthcare budgets capture only part of it, supporting explicit cost attribution alongside the payer perspective.