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Comparative Study
. 2017 Feb;12(3):95-108.

Estimating the Cost of Cancer Care in British Columbia and Ontario: A Canadian Inter-Provincial Comparison

Claire De Oliveira  1 , Reka Pataky  2 , Karen E Bremner  3 , Jagadish Rangrej  4 , Kelvin K W Chan  5 , Winson Y Cheung  6 , Jeffrey S Hoch  7 , Stuart Peacock  8 , Murray D Krahn  9
Affiliations
Comparative Study

Estimating the Cost of Cancer Care in British Columbia and Ontario: A Canadian Inter-Provincial Comparison

Claire De Oliveira et al. Healthc Policy. 2017 Feb.

Abstract
in English, French

Background: Costing studies are useful to measure the economic burden of cancer. Comparing costs between healthcare systems can inform evaluation, development or modification of cancer care policies.

Objectives: To estimate and compare cancer costs in British Columbia and Ontario from the payers' perspectives.

Methods: Using linked cancer registry and administrative data, and standardized costing methodology and analyses, we estimated costs for 21 cancer sites by phase of care to determine potential differences between provinces.

Results: Overall, costs were higher in Ontario. Costs were highest in the initial post-diagnosis and pre-death phases and lowest in the pre-diagnosis and continuing phases, and generally higher for brain cancer and multiple myeloma, and lower for melanoma. Hospitalization was the major cost category. Costs for physician services and diagnostic tests differed the most between provinces.

Conclusions: The standardization of data and costing methodology is challenging, but it enables interprovincial and international comparative costing analyses.

Contexte:: Les études de coûts sont utiles pour mesurer le fardeau économique du cancer. La comparaison des coûts entre systèmes de santé peut éclairer l'évaluation, l'élaboration ou la modification des politiques pour les soins contre le cancer.

Objectif:: Estimer et comparer les coûts pour les soins contre le cancer en Colombie-Britannique et en Ontario du point de vue des payeurs.

Méthode:: Au moyen d'un registre sur le cancer et de données administratives liées, et au moyen d'analyses et d'une méthodologie des coûts normalisés, nous avons estimé le coût de 21 sièges du cancer selon les étapes de soins afin de dégager les différences entre les provinces.

Résultats:: Dans l'ensemble, les coûts sont plus élevés en Ontario. Les coûts étaient plus élevés pour les étapes initiales de post-diagnostic et de pré-mortalité et ils étaient plus bas pour les étapes de pré-diagnostic et de continuité, et généralement plus élevés pour le cancer du cerveau et le myélome multiple, mais moindre pour le mélanome. L'hospitalisation constitue la principale catégorie de coût. Les coûts pour les services de médecins et les tests diagnostics sont ceux qui varient le plus entre les provinces.

Conclusion:: La standardisation des données et des méthodologies pour les coûts présente un défi, mais elle permet d'effectuer des analyses comparatives des coûts interprovinciales et internationales.

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Figures

Figure 1.
Figure 1.
Mean costs (2009 Canadian dollars) for the initial phase of care by resource for the four most common cancers in BC and ON
Figure 2.
Figure 2.
Mean costs (2009 Canadian dollars) for the terminal phase by resource for the four most common cancers in BC and ON
See this image and copyright information in PMC

References

    1. Baker M.S., Kessler L.G., Urban N., Smucker R.C. 1991. “Estimating the Treatment Costs of Breast and Lung Cancer.” Medical Care 29: 40–49. - PubMed
    1. Baladi J.F. 1996. A Guidance Document for the Costing Process, Version 1.0. Ottawa, ON: Canadian Coordinating Office for Health Technology Assessment.
    1. British Columbia Cancer Agency Registry Data. 2012a. “BC Cancer Registry.” Retrieved March 7, 2011. <www.bccancer.bc.ca/HPI/CancerStatistics/>.
    1. British Columbia Ministry of Health (BC MOH). 2012a. Home and Community Care (Continuing Care). Population Data BC. Data Extract. MOH (2012). Retrieved June 18, 2012. <www.popdata.bc.ca/data/internal/health/hcc>.
    1. British Columbia Ministry of Health (BC MOH). 2012b. Medical Services Plan (MSP) Payment Information File. Population Data BC. Data Extract. MOH (2012). Retrieved June 18, 2012. <www.popdata.bc.ca/data/internal/health/msp>.

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