Cost of Cervical Cancer Treatment: Implications for Providing Coverage to Low-Income Women under the Medicaid Expansion for Cancer Care

Subramanian, Sujha; Trogdon, Justin G.; Ekwueme, Donatus U.; Gardner, James G.; Whitmire, J. Timothy; Rao, Chandrika

doi:10.1016/j.whi.2010.07.002

Cited by 44 publications

(43 citation statements)

References 20 publications

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“…Although numerous studies have estimated the cost of care during the same 6-month treatment phase as in our study, we are aware of none that assessed the relationship between specific chronic conditions and costs among Medicaid patients (Subramanian et al, 2010(Subramanian et al, , 2011Brown, Riley, Schussler, & Etzioni, 2002). With the rapid growth rate of chronic conditions, even among the non-elderly U.S. population, such estimates become increasingly important as cancer patients will likely have more comorbid conditions that will need to be managed, while the patients undergo potentially intensive cancer combination therapy involving surgery, chemotherapy and radiation (Imai, Gregg, Cheng, & Zhang, 2006;Partnership to Fight Chronic Diseases, 2009;Boyle, Thompson, Gregg, Barker, & Williamson, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…We compared the distribution of the following characteristics among cancer patients with chronic conditions: age at diagnosis (21-35; 36-50; 51-64 years), race (White, Black, Other), and cancer stage at diagnosis (in situ, localized, regional, distant, unknown) (Subramanian et al, 2010(Subramanian et al, , 2011. We also report the most prevalent tumor sites and groupings based on site information in the cancer registry data.…”

Section: Additional Cost Of Cancer Treatment Due To Presence Of Chronmentioning

confidence: 99%

“…When cancer patients matched with more than two comparison cases, two non-cancer cases were selected at random. This methodology was used in a previous analysis to select an unbiased comparison group of non-cancer enrollees (Subramanian et al, 2010(Subramanian et al, , 2011. In addition, we also ensured that the follow-up period selected for the comparison case was the same (that is, the same months of enrollment) as the cancer case in order to ensure that seasonal differences in cost did not impact our cost estimates.…”

Section: Comparing Additional Costs Of Treating Chronic Conditions Inmentioning

confidence: 99%

“…Although the Medicaid cost of treating cancer has been examined in previous studies, no study to date has assessed differences in Medicaid cost of treating cancer associated with specific chronic conditions (Subramanian et al, 2010(Subramanian et al, , 2011. Some chronic conditions, such as diabetes, have been associated with an increased risk for complications during cancer treatment and with the treatment modalities selected for cancer patients (Srokowski, Fang, Hortobagyi, & Giordano, 2009).…”

Section: Introductionmentioning

confidence: 99%

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Impact of Chronic Conditions on the Cost of Cancer Care for Medicaid Beneficiaries

Subramanian¹,

Tangka²,

Sabatino³

et al. 2012

MMRR

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Background:No study has assessed the cost of treating adult Medicaid cancer patients with preexisting chronic conditions. This information is essential for understanding the cost of cancer care to the Medicaid program above that expended for other chronic conditions, given the increasing prevalence of chronic conditions among cancer patients. Research Design:We used administrative data from 3 state Medicaid programs' linked cancer registry data to estimate cost of care during the first 6 months following cancer diagnosis for beneficiaries with 4 preexisting chronic conditions: cardiac disease, respiratory diseases, diabetes, and mental health disorders. Our base cohort consisted of 6,212 Medicaid cancer patients aged 21 to 64 years (cancer diagnosed during [2001][2002][2003] who were continuously enrolled in fee-for-service Medicaid for 6 months after diagnosis. A subset of these patients who did not die during the 6-month follow-up (n=4,628), were matched with 2 non-cancer patients each (n=8,536) to assess incremental cost of care. Results:The average cost of care for cancer patients with the chronic conditions studied was higher than for cancer patients without any of these conditions. The increase in cancer treatment cost associated with the chronic conditions ranged from $4,385 for cardiac disease to $11,009 for mental health disorders. Conclusions:Chronic conditions, especially the presence of multiple conditions, are associated with a higher cost of care among Medicaid cancer patients, and these increased costs should be reflected in projections of future Medicaid cancer care costs. The implementation of better care-management processes for cancer patients with preexisting chronic conditions may be one way to reduce these costs.

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Section: Discussionmentioning

confidence: 99%

Section: Additional Cost Of Cancer Treatment Due To Presence Of Chronmentioning

confidence: 99%

Section: Comparing Additional Costs Of Treating Chronic Conditions Inmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of Chronic Conditions on the Cost of Cancer Care for Medicaid Beneficiaries

Subramanian¹,

Tangka²,

Sabatino³

et al. 2012

MMRR

Self Cite

View full text Add to dashboard Cite

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“…According to some studies, the average costs for individuals 6 months after a diagnosis of cervical cancer are $3,807, $23,187, $35,853, and $45,028 for in situ, local, regional, and distant cancers, respectively. The incremental costs of cancer treatment for local and regional cancers are $13,935 and $26,174, which increase by 12 months to $15,868 and $30,917, respectively [41]. Thus, in addition to helping to prevent the hardship and adverse effects facing women diagnosed with cervical cancer, screening programs also mitigate the financial burden.…”

Section: Challengesmentioning

confidence: 99%

Human papillomaviruses: The cervical cancer saga in developing countries

Alhamlan

Al‐Ahdal

Al-Zahrani

et al. 2017

J Infect Dev Ctries

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Cervical cancer is the fourth most common cancer affecting women, with worldwide annual incidence and mortality rates of 528,000 and 266,000, respectively, according to the World Health Organization. It is well established that cervical cancer is predominantly caused by a persistent human papillomavirus (HPV) infection of cervical cells. Increasing numbers of studies have investigated HPV and cervical cancer, contributing greatly to the global knowledge and unraveling some of the critical questions regarding HPV transmission, infection, and prevention. However, despite these studies, our knowledge is far from complete and much remains to be discovered. Although molecular detection and HPV prophylactic approaches have greatly advanced in recent years, approximately 85% of the global burden of mortality from cervical cancer still occurs in developing countries. Clinical and molecular epidemiological studies have demonstrated a need for developing countries in general to adopt cervical screening and vaccination programs. However, studies examining cervical cancer screening modalities and HPV prevalence as well as whether HPV vaccination programs should be implemented are lacking at the national level in some developing countries. Therefore, this review describes the current status of HPV in developing countries, presenting some of the existing challenges in implementing cervical screening and HPV vaccination programs.

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Multidimensional financial hardship among uninsured and insured young adult patients with metastatic breast cancer

et al. 2023

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Background Little is known about the heterogeneous nature of financial hardship in younger patients with metastatic disease and the extent to which insurance protects against it. We examine the association between insurance status and multidimensional indicators of financial hardship in a national sample of women with metastatic breast cancer. Methods We conducted a national, retrospective online survey in partnership with the Metastatic Breast Cancer Network. Eligible participants were ≥18 years, diagnosed with metastatic breast cancer, and able to respond in English. We estimated multivariate generalized linear models predicting two distinct dimensions of financial hardship—financial insecurity (the ability to afford care and living costs) and financial distress (the extent of emotional/psychological distress experienced due to costs)—as a function of insurance status. Results Participants responded from 41 states (N = 1054; median age: 44 years). Overall, 30% were uninsured. Financial insecurity was more frequently reported by uninsured respondents. In adjusted analyses, uninsured participants were more likely than insured participants to report contact by debt collectors (adjusted risk ratio [aRR]: 2.38 [2.06, 2.76]) and being unable to meet monthly expenses (aRR: 2.11 [1.68, 2.66]). Financial distress was reported more frequently by insured participants. For example, insured participants were more likely to worry about future financial problems due to cancer and distress about lack of cost transparency. After adjustment, uninsured participants remained about half as likely as insured participants to report financial distress. Conclusions Young adult women with metastatic cancer reported a high burden of financial toxicity. Importantly, insurance does not protect against financial distress; however, the uninsured are the most materially vulnerable.

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Cost of Cervical Cancer Treatment: Implications for Providing Coverage to Low-Income Women under the Medicaid Expansion for Cancer Care

Cited by 44 publications

References 20 publications

Impact of Chronic Conditions on the Cost of Cancer Care for Medicaid Beneficiaries

Impact of Chronic Conditions on the Cost of Cancer Care for Medicaid Beneficiaries

Human papillomaviruses: The cervical cancer saga in developing countries

Multidimensional financial hardship among uninsured and insured young adult patients with metastatic breast cancer

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