Annual financial impact of well‐differentiated thyroid cancer care in the United States

Abstract

Background Well-differentiated thyroid cancer (WDTC) is a prevalent disease, which is increasing in incidence faster than any other cancer. Substantial direct medical care costs are related to the diagnosis and treatment of newly diagnosed patients as well as the ongoing surveillance of patients who have a long life expectancy. Prior analyses of the aggregate healthcare costs attributable to WDTC in the U.S. have not been reported. Methods A stacked cohort cost analysis was performed on the U.S. population from 1985-2013 to estimate the number of WDTC survivors in 2013. Incidence rates, cancer-specific, and overall survival were based on Surveillance, Epidemiology, and End Results data. We then estimated current and projected direct medical care costs attributable to the care of WDTC patients. Health-care related costs and event probabilities were based on Medicare reimbursement schedules and the literature. Results Estimated overall societal cost of WDTC care in 2013 for all U.S. patients diagnosed after 1985 is $1.6 billion. Diagnosis, surgery, and adjuvant therapy for newly diagnosed patients (41%) constitutes the greatest proportion of costs, followed by surveillance of survivors (37%) and non-operative deaths costs attributable to thyroid cancer care (22%). Projected 2030 costs (in 2013 $US) based on current incidence trends exceed $3.5 billion. Conclusion Healthcare costs of WDTC are substantial. Unlike other cancers, the majority of the cost is incurred in the initial and continuing phases of care. With the projected increasing incidence, population, and survival trends, costs will continue to escalate.

Comparison of the costs of active surveillance and immediate surgery in the management of low-risk papillary microcarcinoma of the thyroid

“…For example, Ahn et al reported an increase in thyroid cancer patients with surgical complications in Korea [2]. Lubitz et al warned of a significant possible expansion of the societal medical costs for thyroid cancer in the U.S. [4].…”

“…Medical costs are another important issue. Lubitz et al warned that the $1.6 billion societal cost of thyroid cancer care in the U.S. in 2013 could increase to $3.5 billion by 2030 if the recent trend of the increase in the incidence continues [4]. Medical costs are a very important issue for any society, and it is also a major concern for individual patients.…”

The Impact of Subclinical Disease and Mechanism of Detection on the Rise in Thyroid Cancer Incidence: A Population-Based Study in Olmsted County, Minnesota During 1935 Through 2012

“…This surge of TC cases has been especially pronounced over the last decade, leading to a substantial impact on the cost of care. In 2013, the aggregate national cost of care for well-differentiated TC in the United States was $1.6 billion, and by 2030 it will likely exceed $3.55 billion (3). This economic burden also impacts individuals, since patients with TC are 2.5-fold more likely to file for bankruptcy than those without cancer, a rate that is higher than seen for any other malignancy (4).…”

Dietary iodine intake, thyroid diseases and the prevalence of papillary carcinoma (PTC)

“…A case-control study in Hawaiian adults reported the association between dietary iodine intake and thyroid cancer in 191 cases (85% PTC) and 442 controls [91]. But increasing thyroid cancer rates were not been associated with national iodine intake according to UIC data from US population [92,93], Sweden [94] and Denmark [95,96]. Overall, in the past 2 to 3 decades, there is clear temporal relationship in many countries between introduction of iodized salt and an increase in incidence of PTC [83,[97][98][99][100] (Figure 5).…”