Cancer Survivors’ Long-Term Health Service Costs in Queensland, Australia: Results of a Population-Level Data Linkage Study (Cos-Q)

Merollini, Katharina; Gordon, Louisa G.; Ho, Yiu Ming; Aitken, Joanne; Kimlin, Michael G.

doi:10.3390/ijerph19159473

Cited by 6 publications

(7 citation statements)

References 37 publications

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“…62,63 Our findings show healthcare costs during cancer care follow a U-shape trend, highest during the initial year and end-of-life care, and lowest during the continuing phase. This is consistent with previous studies in the adult population which show a similar trend both during formal care [64][65][66][67][68][69] and informal care. 14 In the study by Cheng Brian & Wangmo, provision of specialist palliative care was associated with lower cost compared to regular endof-life care.…”

Section: Summary Of Evidencesupporting

confidence: 93%

“…In line with our findings, national estimates from Australia on health system costs of cancer show leukemia as one of the costliest cancers among those aged below 20 years. 66,77 Literature for adult populations similarly show leukemia with the highest per-person costs during follow-up care 64,66 and was projected to cost 6.3% of the total global cost of cancers of 2020 to 2050 78 lung, breast, prostate, and colorectal cancers being the most expensive in terms of overall cost burden. We can attribute this to the high cost of chemotherapy 79 and high hospitalization resulting from the cytotoxic effect of leukemia treatment agents.…”

Section: Summary Of Evidencementioning

confidence: 99%

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Healthcare costs of cancer among children, adolescents, and young adults: A scoping review

Nabukalu,

Gordon,

Lowe

et al. 2024

Cancer Medicine

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ObjectiveTo collate and critically review international evidence on the direct health system costs of children and adolescents and young adults (AYA) with cancer.MethodsWe conducted searches in PubMed, MEDLINE, CINAHL, and Scopus. Articles were limited to studies involving people aged 0–39 years at cancer diagnosis and published from 2012 to 2022. Two reviewers screened the articles and evaluated the studies using the Consolidated Health Economic Evaluation Reporting Standards checklist. The reviewers synthesized the findings using a narrative approach and presented the costs in 2022 US dollars for comparability.ResultsOverall, the mean healthcare costs for all cancers in the 5 years post diagnosis ranged from US$36,670 among children in Korea to US$127,946 among AYA in the USA.During the first year, the mean costs among children 0–14 years ranged from US$34,953 in Chile to over US$130,000 in Canada. These were higher than the costs for AYA, estimated at US$61,855 in Canada. At the end of life, the mean costs were estimated at over US$300,000 among children and US$235,265 among adolescents in Canada.Leukemia was the most expensive cancer type, estimated at US$50,133 in Chile, to US$152,533 among children in Canada. Overall, more than a third of the total cost is related to hospitalizations. All the included studies were of good quality.ConclusionsHealthcare costs associated with cancer are substantial among children, and AYA. More research is needed on the cost of cancer in low‐ and middle‐income countries and harmonization of costs across countries.

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Section: Summary Of Evidencesupporting

confidence: 93%

Section: Summary Of Evidencementioning

confidence: 99%

Healthcare costs of cancer among children, adolescents, and young adults: A scoping review

Nabukalu,

Gordon,

Lowe

et al. 2024

Cancer Medicine

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“…This study was conducted in a single, publicly funded hospital with a small sample size. Given the inherent limitations of cross-sectional analysis, it was not possible to assess whether financial toxicity altered over time, although it is known that healthcare costs are highest in the first 12 months since diagnosis [24]. Another limitation was recall bias, where participants needed to remember their out-of-pocket expenses that were incurred 12 to 36 months previously.…”

Section: Discussionmentioning

confidence: 99%

Financial Toxicity and Out-of-Pocket Costs for Patients with Head and Neck Cancer

Smith

Gordon

et al. 2023

Current Oncology

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Aim: To quantify financial toxicity and out-of-pocket costs for patients with HNC in Australia and explore their relationship with health-related quality of life (HRQoL). Methods: A cross-sectional survey was administered to patients with HNC 1–3 years after radiotherapy at a regional hospital in Australia. The survey included questions on sociodemographics, out-of-pocket expenses, HRQoL, and the Financial Index of Toxicity (FIT) tool. The relationship between high financial toxicity scores (top quartile) and HRQoL was explored. Results: Of the 57 participants included in the study, 41 (72%) reported out-of-pocket expenses at a median of AUD 1796 (IQR AUD 2700) and a maximum of AUD 25,050. The median FIT score was 13.9 (IQR 19.5) and patients with high financial toxicity (n = 14) reported poorer HRQoL (76.5 vs. 114.5, p < 0.001). Patients who were not married had higher FIT scores (23.1 vs. 11.1, p = 0.01), as did those with lower education (19.3 vs. 11.1, p = 0.06). Participants with private health insurance had lower financial toxicity scores (8.3 vs. 17.6, p = 0.01). Medications (41%, median AUD 400), dietary supplements (41%, median AUD 600), travel (36%, median AUD 525), and dental (29%, AUD 388) were the most common out-of-pocket expenses. Participants living in rural locations (≥100 km from the hospital) had higher out-of-pocket expenses (AUD 2655 vs. AUD 730, p = 0.01). Conclusion: Financial toxicity is associated with poorer HRQoL for many patients with HNC following treatment. Further research is needed to investigate interventions aimed at reducing financial toxicity and how these can best be incorporated into routine clinical care.

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“…Despite being relatively rare, in 2019–2020 brain and CNS cancers cost the Australian health system AU$152 million while benign PBT cost an additional AU$143 million 5 . Brain cancer has been found to have the highest health system cost per person among lower‐surviving cancers (i.e., those with 5‐year relative survival up to 35%) 6 . There is also an established link between high psychological problems in survivors of other cancer types and high use of health services, healthcare costs, and economic burden 7 .…”

Section: Introductionmentioning

confidence: 99%

“…5 Brain cancer has been found to have the highest health system cost per person among lower-surviving cancers (i.e., those with 5-year relative survival up to 35%). 6 There is also an established link between high psychological problems in survivors of other cancer types and high use of health services, healthcare costs, and economic burden. 7 Therefore, it is critical that mental health issues are addressed in patients with PBT.…”

Section: Introductionmentioning

confidence: 99%

Cost‐utility analysis of a telehealth psychological support intervention for people with primary brain tumor: Telehealth Making Sense of brain tumor

Gordon,

Jones,

Parker

et al. 2023

Psycho-Oncology

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ObjectiveTo undertake an economic evaluation of a telehealth psychological support intervention for patients with primary brain tumor (PBT).MethodsA within‐trial cost‐utility analysis over 6 months was performed comparing a tailored telehealth‐psychological support intervention with standard care (SC) in a randomized control trial. Data were sourced from the Telehealth Making Sense of Brain Tumor (Tele‐MAST) trial survey data, project records, and administrative healthcare claims. Quality‐adjusted life years (QALYs) were calculated based on the EuroQol‐5D‐5L. Non‐parametric bootstrapping with 2000 iterations was used to determine sampling uncertainty. Multiple imputation was used for handling missing data.ResultsThe Tele‐MAST trial included 82 participants and was conducted in Queensland, Australia during 2018–2021. When all healthcare claims were included, the incremental cost savings from Tele‐MAST were ‐AU$4,327 (95% CI: −$8637, −$18) while incremental QALY gains were small at 0.03 (95% CI: −0.02, 0.08). The likelihood of Tele‐MAST being cost‐effective versus SC was 87% at a willingness‐to‐pay threshold of AU$50,000 per QALY gain. When psychological‐related healthcare costs were included only, the incremental cost per QALY gain was AU$10,685 (95% CI: dominant, $24,566) and net monetary benefits were AU$534 (95% CI: $466, $602) with a 65% likelihood of the intervention being cost‐effective.ConclusionsBased on this small randomized controlled trial, the Tele‐MAST intervention is a cost‐effective intervention for improving the quality of life of people with PBT in Australia. Patients receiving the intervention incurred significantly lower overall healthcare costs than patients in SC. There was no significant difference in costs incurred for psychological health services.

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Cancer Survivors’ Long-Term Health Service Costs in Queensland, Australia: Results of a Population-Level Data Linkage Study (Cos-Q)

Cited by 6 publications

References 37 publications

Healthcare costs of cancer among children, adolescents, and young adults: A scoping review

Healthcare costs of cancer among children, adolescents, and young adults: A scoping review

Financial Toxicity and Out-of-Pocket Costs for Patients with Head and Neck Cancer

Cost‐utility analysis of a telehealth psychological support intervention for people with primary brain tumor: Telehealth Making Sense of brain tumor

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