It’s no secret that cancer treatment can be a strain on patients’ finances, but a new study published in the Journal of Clinical Oncology shows that the economic impact of the disease often continues long after treatment is completed.1
Using data from the 2008 to 2010 Medical Expenditure Panel Survey, a representative sample of the US population, researchers from the Centers for Disease Control and Prevention identified 4,960 adult cancer survivors and compared them with 64,431 adults with no history of cancer. The economic burden of surviving cancer was determined by comparing direct medical costs and indirect morbidity costs between the two groups. Survivors and controls were stratified by age (18 to 64 years and ≥ 65 years) and time since diagnosis (≤ 1 year or > 1 year).
Direct medical costs were higher for cancer survivors than they were for controls. Among individuals between the ages of 18 and 64 years, recently diagnosed cancer survivors had mean total medical expenditures of $17,170, compared with $6,485 for previously diagnosed cancer survivors and $3,611 for controls. Cancer survivors aged 65 years or older who were recently diagnosed had mean total medical expenditures of $23,441, compared with $12,357 for previously diagnosed cancer survivors and $8,724 for controls of the same age.
The greatest expenditure among younger patients was for ambulatory care, and; conversely, in-patient care was the greatest expenditure among older patients. Nationwide, total annual medical expenditures for cancer survivors were estimated at $25.2 to $41.7 billion for younger patients and $37.3 to $48.1 billion for older patients.
Indirect costs were also higher for cancer survivors than for controls. Among persons aged 18 to 64 years, costs resulting from reduced productivity were $4,694 for recently diagnosed survivors, $3,593 for previously diagnosed survivors, and $2,040 for controls. Among individuals aged 65 years or older, costs related to reduced productivity did not differ significantly among the three groups, due to the low employment levels in this age group.
Interestingly, for cancer survivors throughout the nation, estimated losses from employment disability, work days missed, and lost productivity were estimated at $9.6 to $16 billion, respectively, in the younger group and $8.2 to $10.6 billion in the older group.
Estimated direct and indirect costs would have been even higher if data on expenditures for terminal care, loss of productivity among caregivers, and patient transportation had been available, the study authors wrote.
This is the first study to measure both medical expenditures and indirect morbidity costs of lost productivity among adult cancer survivors on a nationwide basis. In previous investigations, study populations were limited to Medicare beneficiaries, members of specific managed care plans, residents of particular regions, or patients currently receiving cancer-related health care.
More than 13 million Americans alive today are cancer survivors, a number that is expected to grow as advances in treatment and early detection become available and life expectancy increases. Long-term health effects resulting from cancer treatment include cardiac disease, lymphedema, sexual dysfunction, incontinence, pain and fatigue, cognitive dysfunction, and psychological distress, all of which contribute to direct and indirect costs.
- Guy GP Jr, Ekwueme DU, Yabroff KR, et al. Economic burden of cancer survivorship among adults in the United States. J Clin Oncol. 2013;31(30):3749-3757.