Lifetime and Treatment-Phase Costs Associated With Colorectal Cancer: Evidence from SEER-Medicare Data

Lang, Kathleen; Lines, Lisa; Lee, David W.; Korn, Jonathan R.; Earle, Craig C.; Menzin, Joseph

doi:10.1016/j.cgh.2008.08.034

Cited by 86 publications

(78 citation statements)

References 17 publications

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“…First, it covered subjects of all ages. Previous reports from the United States used Medicare data, which only included patients over 65 years of age Lang et al, 2009;Yabroff et al, 2008a). The cost of cancer differs according age (Brown et al, 2001;Warren et al, 2002), with younger patients tending to receive more aggressive therapy Smith et al, 1995).…”

Section: Discussionmentioning

confidence: 99%

“…Notably, in the liver cancer group, a higher cost resulted if a cancer was in the localized stage, rather than the advanced stage, at the time of diagnosis. The more advanced the cancer stage is, the higher the cost will be (Fireman et al, 1997;Lang et al, 2009;Yabroff et al, 2008a); however, in cancers that are difficult to diagnose at an early stage or that have relatively low survival rates, such as esophageal, gastric, lung, and pancreatic cancers, cost differences according to cancer stage at the time of diagnosis are small (Yabroff et al, 2008a). This supports the present study results, suggesting that early detection through screening is an important aspect of medical costs.…”

Section: Discussionmentioning

confidence: 99%

“…Total medical costs, patients' co-payments, insurer payments, and pharmaceutical costs were analyzed for the six aforementioned cancers. For a maximum of 5 years during the follow-up evaluation, we used nonparametric Kaplan-Meier sample average estimator modeling techniques to analyze censored cost data (Lang et al, 2009). The Kaplan-Meier sample average estimator is known to minimize the bias associated with censored data by dividing the time period into short intervals (Lang et al, 2009).…”

Section: Methodsmentioning

confidence: 99%

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Costs During the First Five Years Following Cancer Diagnosis in Korea

Shin¹,

Kim²,

Lee³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Objectives: We estimated the total medical costs incurred during the 5 years following a cancer diagnosis and annual medical use status for the six most prevalent cancers in Korea. Methods: From January 1 to December 31, 2006, new patients registered with the six most prevalent cancers (stomach, liver, lung, breast, colon, and thyroid) were randomly selected from the Korea Central Cancer Registry, with 30% of patients being drawn from each cancer group. For the selected patients, cost data were generated using National Health Insurance claims data from the time of cancer diagnosis in 2006 to December 31, 2010. The total number of patients selected was 28,509. Five-year total medical costs by tumor site and Surveillance, Epidemiology, and End Results (SEER) stage at the time of diagnosis, and annual total medical costs from diagnosis, were estimated. All costs were calculated as per-patient net costs. Results: Mean 5-year net costs per patient varied widely, from $5,647 for thyroid cancer to $20,217 for lung cancer. Advanced stage at diagnosis was associated with a 1.8-2.5-fold higher total cost, and the total medical cost was highest during the first year following diagnosis and decreased by the third or fourth year. Conclusions: The costs of cancer care were substantial and varied by tumor site, annual phase, and stage at diagnosis. This indicates the need for increased prevention, earlier diagnosis, and new therapies that may assist in reducing medical costs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Costs During the First Five Years Following Cancer Diagnosis in Korea

Shin¹,

Kim²,

Lee³

et al. 2012

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

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“…1). 4 The health care debate that resulted in health care reform in the United States prompted The Lancet to point out that debates comparing British and American health systems became national pastimes on both sides of the Atlantic. 5 In CRC, the challenge of simultaneously saving lives and money while enacting reform could depend more on advances in a molecular genetics laboratory, whether in Helsinki or Houston or Tel Aviv, than in a clinical setting in New York, California, or any other state.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers, Bundled Payments, and Colorectal Cancer Care

Ross¹,

Lynch²,

Raju³

et al. 2012

Genes & Cancer

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Changes in the management of cancers such as colorectal cancer (CRC) are urgently needed, as such cancers continue to be one of the most commonly diagnosed cancers; CRC accounts for 21% of all cancers and is responsible for mortalities second only to lung cancer in the United States. A comprehensive science-driven approach towards markedly improved early detection/screening to efficacious targeted therapeutics with clear diagnostic and prognostic markers is essential. In addition, further changes addressing rising costs, stemming from recent health care reform measures, will be brought about in part by changes in how care is reimbursed. For oncology, the advances in genomics and biomarkers have the potential to define subsets of patients who have a prognosis or response to a particular type of therapy that differs from the mean. Better definition of a cancer's behavior will facilitate developing care plans tailored to the patient. One method under study is episode-based payment or bundling, where one payment is made to a provider organization to cover all expenses associated with a discrete illness episode. Payments will be based on the average cost of care, with providers taking on a risk for overutilization and outliers. For providers to thrive in this environment, they will need to know what care a patient will require and the costs of that care. A science-driven "personalized approach" to cancer care has the potential to produce better outcomes with reductions in the use of ineffectual therapies and costs. This promising scenario is still in the future, but progress is being made, and the shape of things to come for cancer care in the age of genomics is becoming clearer.

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“…2 Most of this expense is concentrated in the first year after diagnosis, as a result of multimodality treatment costs. 4,5 Traditionally, Medicare makes separate payments to these multidisciplinary providers for each service they perform for the beneficiaries (ie, fee-for-service payments). This approach results in fragmented care and a compartmentalized delivery system, with multiple providers across many health care settings.…”

Section: Introductionmentioning

confidence: 99%

Variation in Medicare Payments for Colorectal Cancer Surgery

Abdelsattar

Birkmeyer

Wong

2015

JOP

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Purpose: Colorectal cancer (CRC) is the second most expensive cancer in the United States. Episode-based bundled payments may be a strategy to decrease costs. However, it is unknown how payments are distributed across hospitals and different perioperative services. Methods:We extracted actual Medicare payments for patients in the fee-for-service Medicare population who underwent CRC surgery between January 2004 and Decembe 2006 (N ϭ 105,016 patients). Payments included all service types from the date of hospitalization up to 1 year later. Hospitals were ranked from least to most expensive and grouped into quintiles. Results were case-mix adjusted and price standardized using empirical Bayes methods. We assessed the contributions of index hospitalization, physician services, readmissions, and postacute care to the overall variation in payment.Results: There is wide variation in total payments for CRC care within the first year after CRC surgery. Actual Medicare payments were $51,345 per patient in the highest quintile and $26,441 per patient in the lowest quintile, representing a difference of ⌬ ϭ $24,902. Differences were persistent after price standardization (⌬ ϭ $17,184 per patient) and case-mix adjustment (⌬ ϭ $4,790 per patient). Payments for the index surgical hospitalization accounted for the largest share (65%) of payments but only minimally varied (11.6%) across quintiles. However, readmissions and postacute care services accounted for substantial variations in total payments. Conclusion:Medicare spending in the first year after CRC surgery varies across hospitals even after case-mix adjustment and price standardization. Variation is largely driven by postacute care and not the index surgical hospitalization. This has significant implications for policy decisions on how to bundle payments and define episodes of surgical CRC care.

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Lifetime and Treatment-Phase Costs Associated With Colorectal Cancer: Evidence from SEER-Medicare Data

Cited by 86 publications

References 17 publications

Costs During the First Five Years Following Cancer Diagnosis in Korea

Costs During the First Five Years Following Cancer Diagnosis in Korea

Biomarkers, Bundled Payments, and Colorectal Cancer Care

Variation in Medicare Payments for Colorectal Cancer Surgery

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