Estimating Health Care Costs Related to Cancer Treatment From SEER-Medicare Data

Brown, Martin L.; Riley, Gerald F.; Schussler, Nicki; Etzioni, Ruth

doi:10.1097/00005650-200208001-00014

Cited by 359 publications

(378 citation statements)

References 15 publications

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“…Brown et al (34) a Anaesthetic is included in the thyroidectomy DRG; b This cost is the discounted lifetime cost, with a discount rate of 3% per annum applied; Since the model uses a 5% discount rate, this cost is conservative. time off-work for patients undergoing hypothyroid preparation.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of using recombinant human TSH prior to radioiodine ablation for thyroid cancer, compared with treating patients in a hypothyroid state: the German perspective

Mernagh¹,

Campbell²,

Dietlein³

et al. 2006

eur j endocrinol

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Objective: This investigation evaluated the cost-effectiveness of radioiodine remnant ablation following preparation with recombinant human TSH (rhTSH), compared with the standard preparation, whereby patients are rendered hypothyroid. Design: The economic evaluation relates to patients with well differentiated thyroid cancer who have undergone thyroidectomy, but have no metastases. The evaluation takes a societal perspective, considering costs and benefits to all parties. The benefits were expressed in units of quality-adjusted life years (QALY), so differences in life expectancy were captured with consideration of quality of life. Methods: A lifetime Markov model with Monte Carlo simulation of 100 000 patients was used to assess cost per QALY gained. The clinical inputs were sourced from a multi-centre, randomised controlled trial comparing remnant ablation success after rhTSH-preparation with hypothyroid preparation. The model applied German unit costs, however, the structure is generalisable to other jurisdictions. The additional cost of rhTSH procurement and administration is considered relative to the clinical benefits and cost offsets. These included avoidance of hypothyroidism, increased work productivity, earlier discharge from radioprotection and a theoretical reduction in the risk of secondary malignancy. The latter two benefits relate to faster radioiodine clearance after rhTSH preparation. Results: The additional benefits of rhTSH (0.0495 QALY) are obtained with an incremental societal cost of V47, equating to an incremental cost per QALY of V958. Sensitivity analyses had only a modest impact upon cost-effectiveness, with all one-way sensitivity results remaining under V15 000/QALY. Conclusions: The use of rhTSH prior to radioiodine ablation represents good value-for-money with the benefits to patient and society obtained at modest net cost. 155 405-414 European Journal of Endocrinology

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of using recombinant human TSH prior to radioiodine ablation for thyroid cancer, compared with treating patients in a hypothyroid state: the German perspective

Mernagh¹,

Campbell²,

Dietlein³

et al. 2006

eur j endocrinol

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“…We calculated costs in the short-term (months À1 through 12 from diagnosis), the long-term (each 12-month period thereafter), and total 5-year costs (months À1 through 60 from diagnosis). We adjusted for the combination of inflation and different Medicare reimbursements by geographic region using methods similar to those of Brown et al 13 and Zeliadt et al, 9 with data provided by Information Management Services, Inc. (IMC).…”

Section: Study Populationmentioning

confidence: 99%

“…Sixth, our cost estimates relied on the incremental costs of men with prostate cancer compared with matched men without a cancer diagnosis. This approach has been used previously, 13 and has the advantage of providing a more comprehensive estimate of the costs of prostate cancer, but it does not assess which health services were specifically related to prostate cancer. Seventh, we only followed men for 5 years postdiagnosis.…”

Section: Original Article 5396mentioning

confidence: 99%

How does initial treatment choice affect short‐term and long‐term costs for clinically localized prostate cancer?

Snyder

Frick

Blackford³

et al. 2010

Cancer

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BACKGROUND. Data regarding costs of prostate cancer treatment are scarce. This study investigates how initial treatment choice affects short-term and long-term costs. METHODS. This retrospective, longitudinal cohort study followed prostate-cancer cases diagnosed in 2000 for 5 years using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Men age !66 years, in Medicare fee for service, diagnosed with clinically localized prostate cancer in 2000 while residing in a SEER region, were matched to noncancer controls using age, sex, race, region, comorbidity, and survival. On the basis of treatment received during the first 9 months postdiagnosis, patients were assigned to watchful waiting, radiation, hormonal therapy, hormonal þ radiation, and surgery (may have received other treatments). Incremental costs for prostate cancer were the difference in costs for prostate cancer cases versus matched controls. Costs were divided into initial treatment (months À1 to 12), long-term (each 12 months thereafter), and total (months À1 to 60). Sensitivity analyses excluded the last 12 months of life. RESULTS. A total of 13,769 prostate-cancer cases were matched to 13,769 noncancer controls. Watchful waiting had the lowest initial treatment ($4270) and 5-year total costs ($9130). Initial treatment costs were highest for hormonal þ radiation ($17,474) and surgery ($15,197). At $26,896, 5-year total costs were highest for hormonal therapy only followed by hormonal þ radiation ($25,097) and surgery ($19,214). After excluding the last 12 months of life, total costs were highest for hormonal þ radiation ($23,488) and hormonal therapy ($23,199). CONCLUSIONS. Patterns of costs vary widely based on initial treatment. These data can inform patients and clinicians considering treatment options and policy makers interested in patterns of costs. Cancer 2010;116:5391-9.

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“…Annually the cost of medical care for cancer accounts for about 5% of national health care expenditures and 10% of Medicare outlays (1)(2)(3). Much of what we know about the cost of preventing, diagnosing, and treating cancer in the United States comes from research based on the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) cancer registries, which are linked to Medicare claims from the Centers for Medicare and Medicaid Services (CMS) and known as the SEER-Medicare data (1,2,4,5).…”

Section: Measuring the Medical Cost Of Cancermentioning

confidence: 99%

“…Much of what we know about the cost of preventing, diagnosing, and treating cancer in the United States comes from research based on the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) cancer registries, which are linked to Medicare claims from the Centers for Medicare and Medicaid Services (CMS) and known as the SEER-Medicare data (1,2,4,5). This rich data resource provides comprehensive health-care use and claims expense information about Medicare-covered services for persons aged 65 and over, and permanently disabled persons who receive care through the traditional Medicare indemnity program, living in one of the 17 US geographic regions covered by the SEER program.…”

Section: Measuring the Medical Cost Of Cancermentioning

confidence: 99%

A Standardized Relative Resource Cost Model for Medical Care: Application to Cancer Control Programs

et al. 2013

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Medicare data represent 75% of aged and permanently disabled Medicare beneficiaries enrolled in the fee-for-service (FFS) indemnity option, but the data omit 25% of beneficiaries enrolled in Medicare Advantage health maintenance organizations (HMOs). Little research has examined how longitudinal patterns of utilization differ between HMOs and FFS. The Burden of Cancer Study developed and implemented an algorithm to assign standardized relative costs to HMO and Medicare FFS data consistently across time and place. Medicare uses 15 payment systems to reimburse FFS providers for covered services. The standardized relative resource cost algorithm (SRRCA) adapts these various payment systems to utilization data. We describe the rationale for modifications to the Medicare payment systems and discuss the implications of these modifications. We applied the SRRCA to data from four HMO sites and the linked Surveillance, Epidemiology, and End Results-Medicare data. Some modifications to Medicare payment systems were required, because data elements needed to categorize utilization were missing from both data sources. For example, data were not available to create episodes for home health services received, so we assigned costs per visit based on visit type (nurse, therapist, and aide). For inpatient utilization, we modified Medicare's payment algorithm by changing it from a flat payment per diagnosis-related group to daily rates for diagnosis-related groups to differentiate shorter versus longer stays. The SRRCA can be used in multiple managed care plans and across multiple FFS delivery systems within the United States to create consistent relative cost data for economic analyses. Prior to international use of the SRRCA, data need to be standardized.

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Estimating Health Care Costs Related to Cancer Treatment From SEER-Medicare Data

Cited by 359 publications

References 15 publications

Cost-effectiveness of using recombinant human TSH prior to radioiodine ablation for thyroid cancer, compared with treating patients in a hypothyroid state: the German perspective

Cost-effectiveness of using recombinant human TSH prior to radioiodine ablation for thyroid cancer, compared with treating patients in a hypothyroid state: the German perspective

How does initial treatment choice affect short‐term and long‐term costs for clinically localized prostate cancer?

A Standardized Relative Resource Cost Model for Medical Care: Application to Cancer Control Programs

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