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Estimating the Cost of Cancer: Results on the Basis of Claims Data Analyses for Cancer Patients Diagnosed With Seven Types of Cancer During 1999 to 2000

From the Medstat Inc, Washington, DC; Eli Lilly and Company, Indianapolis, IN; Medstat Inc, Cambridge, MA; MidWest Center for Health Services Research and Policy Studies, VA Chicago Health Care System, Lakeside Division, Division of Hematology/Oncology, Center for Healthcare Studies, and Cancer Control Program of the Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL

Address reprint requests to Stella Chang, MPH, Medstat Inc, 4301 Connecticut Avenue, NW, Suite 330, Washington, DC 20008; e-mail: stella.chang{at}thomson.com

PURPOSE: Cancer accounts for $60.9 billion in direct medical costs and $15.5 billion for indirect morbidity costs. These estimates are derived primarily from national surveys or Federal databases. We derive estimates of the costs of cancer using administrative databases, which include claims and employment-related information on individuals insured by private or Medicare supplemental health plans.

METHODS: A retrospective matched-cohort control analysis was performed using 1998 to 2000 databases with information on insurance claims, benefits, and health productivity for 3 million privately insured employees, their dependents, and early retirees. Study patients had new diagnoses of one of seven types of cancer (n = 12,709). Controls without cancer were matched at a 3:1 ratio by demographics. A variable follow-up length was used (maximum of 2 years). Direct costs included health care costs for patients and deductibles and copayments for caregivers. Indirect costs of work absence and short-term disability (STD) were calculated for a subgroup of cancer patients and caregivers.

RESULTS: Mean monthly health care costs ranged from $2,187 for prostate cancer to $7,616 for pancreatic cancer, most often driven by hospitalization. Costs for controls were $329 per month. Indirect morbidity costs to employees with cancer averaged $945, a result of a mean monthly loss of 2.0 workdays and 5.0 STD days.

CONCLUSION: The economic burden of cancer is substantial. It is feasible to derive tumor-specific estimates of direct and indirect costs for large numbers of cancer patients using administrative databases. Policy makers charged with providing annual cost-of-cancer estimates should incorporate data obtained from a broad range of sources.

Supported by Eli Lilly and Company.

Partial results of this analysis have been presented at the following conferences: 39th Annual Meeting of the American Society of Clinical Oncology, Chicago, IL, May 31-June 3, 2003; American Society of Hematology, Philadelphia, PA, December 7-10, 2002; International Society of Pharmacoeconomics and Outcomes Research, Arlington, VA, May 18-21, 2003; World Congress on Lung Cancer, Vancouver, Canada, August 10-14, 2003; and European Society of Gynaecological Oncology, Brussels, Belgium, April 6-9, 2003.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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