Cost Trajectories for Cancer Patients

Wodchis, Walter P.; Arthurs, Erin; Khan, Anum Irfan; Gandhi, Sima; MacKinnon, Marnie; Sussman, Jonathan

doi:10.3747/co.23.2995

Cited by 20 publications

(17 citation statements)

References 24 publications

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“…These findings are consistent with those of previous studies reporting significant increases in costs associated with advancing disease stages 4,5,11,16 and the presence of comorbidities, 11 suggesting the importance of co-management of physical and mental chronic conditions 40,41 and improving access to preventive cancer screening services for older women. Emerging healthcare delivery models, such as “medical homes,” that emphasize care coordination for Medicare beneficiaries with multiple chronic conditions could be a step in the right direction to curb increasing costs associated with BC care.…”

Section: Discussionsupporting

confidence: 92%

Healthcare Utilization and Costs During the Initial Phase of Care Among Elderly Women With Breast Cancer

Vyas¹,

Madhavan²,

Sambamoorthi³

et al. 2017

J Natl Compr Canc Netw

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Background Understanding the patterns of healthcare utilization and costs during the initial phase of care (12 months after breast cancer [BC] diagnosis) in older women (aged ≥65 years) is crucial in the allocation of Medicare resources. The objective of this study was to determine healthcare utilization and costs during the initial phase of care in older, female, Medicare fee-for-service beneficiaries diagnosed with BC, and to determine the factors associated with higher costs. Methods A retrospective observational study using the SEER-Medicare linked database was conducted in 69,307 women aged ≥66 years diagnosed with primary incident BC in 2003–2009 to determine healthcare utilization, average costs, and costs for specific services during the initial phase of care. Generalized linear model regression was conducted to identify the factors associated with higher costs in a multivariate framework. Results A total of 96% of women were treated with surgery during the initial phase of BC care, whereas 21% and 54% underwent chemotherapy and radiotherapy, respectively. Costs during the initial phase of care totalled $28,075 in 2012 USD, comprising $13,344 for physician services and $7,456 for outpatient services. Factors associated with higher costs during the initial phase of care were younger age (66–69 years), African American race, higher household income, advanced stages of BC, initial BC treatment, higher number of primary care physician visits, and presence of comorbidities and/or a mental condition. Conclusions The economic burden of BC is substantial during the initial phase of care. Physician and outpatient services accounted for the highest proportion of costs. Predisposing factors, need-related factors, healthcare use, and external environmental healthcare factors significantly predicted costs during the initial phase of care.

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Section: Discussionsupporting

confidence: 92%

Healthcare Utilization and Costs During the Initial Phase of Care Among Elderly Women With Breast Cancer

Vyas¹,

Madhavan²,

Sambamoorthi³

et al. 2017

J Natl Compr Canc Netw

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“…This finding is consistent with the literature on the impact of comorbidities on health care costs among cancer patients. For example, one study on newly diagnosed cancer patients found that patients with four or more comorbid conditions were much more likely (OR = 2.5, 95% CI: 2.26 to 2.76) to be in the top 10% in terms of health spending . Another study estimated that the increase in cancer treatment cost associated with the chronic conditions during the first 6 months after cancer diagnosis ranged from $4,385 for cardiac disease to $11,009 for mental health disorders .…”

Section: Discussionmentioning

confidence: 99%

Carcinoid Syndrome and Costs of Care During the First Year After Diagnosis of Neuroendocrine Tumors Among Elderly Patients

et al. 2017

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This is the first population-based study that examines the health care costs associated with carcinoid syndrome among neuroendocrine tumor patients. Among patients alive throughout the first year, the unadjusted analyses showed that total median monthly costs were above $1,000 higher ($3,801 vs. $2,481) for patients with carcinoid syndrome compared with patients without. A significant association was found between carcinoid syndrome and higher total inpatient and outpatient costs among the group that survived the whole year even after controlling for clinical factors, treatment received, and demographics and neighborhood socioeconomic status; the association was insignificant among the group that died within the first year of diagnosis.

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“…Patients with a comorbidity score of 1 incurred higher costs in the initial and terminal phase in comparison with patients with a comorbidity score of 0. Previous research showed that increasing comorbidities is a significant predictor of high costs . In the course of cancer diagnosis and treatment, patients and healthcare providers may give less attention to chronic disease management.…”

Section: Discussionmentioning

confidence: 99%

“…Previous research showed that increasing comorbidities is a significant predictor of high costs. [42] In the course of cancer diagnosis and treatment, patients and healthcare providers may give less attention to chronic disease management. For example, there may be less emphasis on routine diabetes management which could have a negative impact on health outcomes and costs.…”

Section: Discussionmentioning

confidence: 99%

An economic evaluation of conservative management and cryotherapy in patients with localized prostate cancer

Shah

Young

Cobran

2018

J Pharm Health Serv Res

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Objectives Cost of care in localized prostate cancer varies widely with treatments and phases of care. This study aimed to evaluate the total direct medical costs and phase‐specific costs associated with two minimally invasive treatment options (conservative management and cryotherapy) from Medicare perspective in patients with localized prostate cancer. Methods The Surveillance, Epidemiology, and End Result program linked to the Medicare data from 2000 to 2014 was utilized. The total direct medical cost and phase‐specific costs were calculated from Medicare's perspective. Phase‐specific costs were divided into three phases: initial, continuing and terminal phases. Cost was presented at 2014 US dollar values. Nonparametric bootstrapping and generalized linear models with gamma distribution and log link function were performed. Key findings The average total direct cost of cancer care in the conservative management and cryotherapy cohort was approximately $13 664 and $14 312 respectively. Compared to the cryotherapy cohort, patients in the conservative management cohort had significantly lower cost in the initial ($3708 versus $4780), continuing ($1504 versus $2253) and the terminal phases of care ($13 387 versus $15 532). Results from the generalized linear model showed that conservative management incurred significantly lower costs across all phases of care compared with cryotherapy after adjusting for the covariates. Conclusions This study shows the importance of conservative management as a cost‐saving strategy for patients with prostate cancer across all the phases of care. The findings could guide policymakers in allocating resources more efficiently.

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Cost Trajectories for Cancer Patients

Abstract: Background Health care spending is known to be highly skewed, with a small subset of the population consuming a

Cited by 20 publications

References 24 publications

Healthcare Utilization and Costs During the Initial Phase of Care Among Elderly Women With Breast Cancer

Healthcare Utilization and Costs During the Initial Phase of Care Among Elderly Women With Breast Cancer

Carcinoid Syndrome and Costs of Care During the First Year After Diagnosis of Neuroendocrine Tumors Among Elderly Patients

An economic evaluation of conservative management and cryotherapy in patients with localized prostate cancer

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