Medicare Payments from Diagnosis to Death for Elderly Cancer Patients by Stage at Diagnosis

Riley, Gerald F.; Potosky, Arnold L.; Lubitz, James; Kessler, Larry G.

doi:10.1097/00005650-199508000-00007

Cited by 310 publications

(199 citation statements)

References 0 publications

Supporting

Mentioning

184

Contrasting

Unclassified

Order By: Relevance

“…These estimates are of a similar magnitude to the direct medical costs associated with cancer care. [24][25][26] The number of cancer survivors is expected to increase in future years, because the cancer incidence increases with age, 1 life expectancy is increasing, and the US population is aging and growing. In addition, ongoing efforts to control healthcare costs in the United States and shorter hospitalizations suggest even greater reliance on informal caregiving in the future.…”

Section: Discussionmentioning

confidence: 99%

“…20 In addition, the relative caregiver time cost across tumor sites, with higher estimates for caregivers of lung and ovarian cancer patients and lower estimates for caregivers of breast cancer patients, is consistent with studies that report direct medical and patient time costs associated with cancer care. 22,[24][25][26] Exploring and understanding the clinical, patient, and caregiver factors associated with the content and intensity of caregiving will be an important area for additional research.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Time costs associated with informal caregiving for cancer survivors

Yabroff¹,

Kim²

2009

Cancer

262

216

View full text Add to dashboard Cite

BACKGROUND:To the authors' knowledge, little work has been done to estimate the time costs associated with informal caregiving for cancer survivors.METHODS:Data from a national survey of caregivers of cancer patients in 2003 to 2006 were used to estimate the time associated with informal caregiving in the 2 years after patient diagnosis with bladder, breast, colorectal, kidney, lung, melanoma of the skin, ovarian, prostate, or uterine cancer, or non‐Hodgkins lymphoma (NHL). Caregivers reported the duration and daily intensity of caregiving as well as the types and frequency of support provided. The median wage rate in 2006 ($16.28) was used to value caregiver time, and other methods to value time were evaluated with sensitivity analyses.RESULTS:On average, caregivers provided care for 8.3 hours per day for 13.7 months. The number of months and daily hours spent caregiving were the highest for cancer survivors diagnosed with distant disease compared with survivors with regional or localized disease (P < .05). Approximately half of caregivers provided emotional, instrumental, tangible, or medical support, although the frequency varied dramatically. Informal caregiver time costs over the 2‐year period after diagnosis were the highest for caregivers of patients diagnosed with lung ($72,702; 95% confidence interval [95% CI], $56,814‐$88,590) and ovarian ($66,210; 95% CI, $40,750‐$91,670) cancers and NHL ($59,613; 95% CI, $43,423‐$75,803) and the lowest for caregivers of patients with breast cancer ($38,334; 95% CI, $31,442‐$45,226).CONCLUSIONS:Time spent by informal caregivers was substantial and was an important component of the burden of cancer care. Incorporation of the value of informal caregiver time will be important when evaluating the costs and benefits of cancer control interventions. Cancer 2009;115(18 suppl):4362–73. © 2009 American Cancer Society.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Time costs associated with informal caregiving for cancer survivors

Yabroff¹,

Kim²

2009

Cancer

262

216

View full text Add to dashboard Cite

show abstract

“…However, even the capture and calculation of these costs is a formidable and, at times, frustrating task, as has been observed by others (Hillner, 1993). In an attempt to compare our Canadian breast cancer costs with those of American researchers, we reviewed the work of Baker et al (1991), Taplin et al (1995) and Riley et al (1995). In all of these articles, there appears to be consensus that breast cancer costs can be separated into the cost of initial therapy, ongoing or maintenance care, and terminal care.…”

Section: Discussionmentioning

confidence: 99%

“…The average cost of initial therapy in Canada in 1995 ($8315 Cdn or $6053 US) is considerably less than the estimates from the above-cited articles. When their costs are converted to 1995 dollars, they range from $15 536 (Baker et al, 1991) to $12 424 (Taplin et al, 1995) to $11 792 (Riley et al, 1995). There are two plausible reasons for the difference in costs.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and therapeutic approaches for nonmetastatic breast cancer in Canada, and their associated costs

et al. 1999

View full text Add to dashboard Cite

In an era of fiscal restraint, it is important to evaluate the resources required to diagnose and treat serious illnesses. As breast cancer is the major malignancy affecting Canadian women, Statistics Canada has analysed the resources required to manage this disease in Canada, and the associated costs. Here we report the cost of initial diagnosis and treatment of nonmetastatic breast cancer, including adjuvant therapies. Treatment algorithms for Stages I, II, and III of the disease were derived by age group (< 50 or ≥ 50 years old), principally from Canadian cancer registry data, supplemented, where necessary, by the results of surveys of Canadian oncologists. Data were obtained on breast cancer incidence by age, diagnostic work-up, stage at diagnosis, initial treatment, follow-up practice, duration of hospitalization and direct care costs. The direct health care costs associated with ‘standard’ diagnostic and therapeutic approaches were calculated for a cohort of 17 700 Canadian women diagnosed in 1995. Early stage (Stages I and II) breast cancer represented 87% of all incident cases, with 77% of cases occurring in women ≥ 50 years. Variations were noted in the rate of partial vs total mastectomy, according to stage and age group. Direct costs for diagnosis and initial treatment ranged from $8014 for Stage II women ≥ 50 years old, to $10 897 for Stage III women < 50 years old. Except for Stage III women < 50 years old, the largest expenditure was for hospitalization for surgery, followed by radiotherapy costs. Chemotherapy was the largest cost component for Stage III women < 50 years old. This report describes the cost of diagnosis and initial treatment of nonmetastatic breast cancer in Canada, assuming current practice patterns. A second report will describe the lifetime costs of treating all stages of breast cancer. These data will then be incorporated into Statistics Canada's Population Health Model (POHEM) to perform cost-effectiveness studies of new therapeutic interventions for breast cancer, such as the cost-effectiveness of day surgery, or of radiotherapy to all breast cancer patients undergoing breast surgery. © 1999 Cancer Research Campaign

show abstract

“…5 Moreover, drug spending trends are complex and are affected by many factors, including disease prevalence, demographics, changes in treatment patterns, new scientific advances, and inflation. 6 Previous studies have examined the overall economic impact of cancer, 7,8 the direct costs of cancer care by type of tumor, 9 -11 stage at diagnosis, 12 and phase of care, 13 but there is surprisingly little quantitative information on drug costs for cancer as a whole. To our knowledge, no analysis has examined the specific components of drug spending for overall cancer care.…”

mentioning

confidence: 99%

Outpatient cancer drug costs

Halbert

Zaher

Wade

et al. 2002

Cancer

View full text Add to dashboard Cite

BACKGROUNDTo the authors' knowledge, no analysis has examined the specific components of drug spending for overall cancer care. The authors' objective was to quantify and characterize trends in outpatient drug expenditures for cancer patients.METHODSThe authors retrospectively analyzed pharmacy and outpatient professional claims data from commercial and Medicare health maintenance organization enrollees with a solid tumor diagnosis in 1995 and 1998. Charges were subdivided by type of drug (antineoplastic drugs, chemotherapy adjuncts, supportive drugs, and drugs unrelated to cancer treatment).RESULTSIn 1995, 14,663 cancer patients received outpatient drug treatment and 13,829 patients in 1998. Total charges increased from $17.9 million (mean charge of $1218 per patient) to $27.9 million (mean charge of $2003 per patient), an average annual increase of 16%. Antineoplastic therapy constituted the largest component of cancer‐related drug costs (67%) and represented 76% of the increase from 1995 to 1998. Most charges were incurred in the professional setting for agents administered by injection. The primary explanation for the increases appeared to be a shift in treatment patterns toward newer, more expensive antineoplastic agents. Supportive therapy represented 17% of the increase in cancer drug costs, followed by chemotherapy adjuncts (7%). Charges for drugs unrelated to cancer therapy increased by 21% per year.CONCLUSIONSAntineoplastic therapy administered in an office or clinic was the single most important cost driver, with newer more expensive agents replacing older, less expensive drugs. Attempts to understand and control outpatient drug cost increases for cancer patients should focus primarily on antineoplastic therapy, especially the appropriate substitution of newer agents for older, less expensive alternatives. Some nonchemotherapy cancer drugs may offer an opportunity to improve quality of life with a relatively small effect on overall cancer drug costs. Cancer 2002;94:1142–50. © 2002 American Cancer Society.DOI 10.1002/cncr.10347

show abstract

Medicare Payments from Diagnosis to Death for Elderly Cancer Patients by Stage at Diagnosis

Cited by 310 publications

References 0 publications

Time costs associated with informal caregiving for cancer survivors

Time costs associated with informal caregiving for cancer survivors

Diagnostic and therapeutic approaches for nonmetastatic breast cancer in Canada, and their associated costs

Outpatient cancer drug costs

Contact Info

Product

Resources

About