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. 2019 Jan;8(1):94-103.
doi: 10.1002/cam4.1896. Epub 2018 Dec 21.

Lung cancer costs by treatment strategy and phase of care among patients enrolled in Medicare

Deirdre F Sheehan  1 , Steven D Criss  1 , Yufan Chen  1 , Andrew Eckel  1 , Lauren Palazzo  1 , Angela C Tramontano  1 , Chin Hur  1   2 , Lauren E Cipriano  3 , Chung Yin Kong  1   4
Affiliations

Lung cancer costs by treatment strategy and phase of care among patients enrolled in Medicare

Deirdre F Sheehan et al. Cancer Med. 2019 Jan.

Abstract

Background: We studied trends in lung cancer treatment cost over time by phase of care, treatment strategy, age, stage at diagnosis, and histology.

Methods: Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database for years 1998-2013, we allocated total and patient-liability costs into the following phases of care for 145 988 lung cancer patients: prediagnosis, staging, surgery, initial, continuing, and terminal. Patients served as self-controls to determine cancer-attributable costs based on individual precancer diagnosis healthcare costs. We fit linear regression models to determine cost by age and calendar year for each stage at diagnosis, histology, and treatment strategy and presented all costs in 2017 US dollars.

Results: Monthly healthcare costs prior to lung cancer diagnosis were $861 for a 70 years old in 2017 and rose by an average of $17 per year (P < 0.001). Surgery in 2017 cost $30 096, decreasing by $257 per year (P = 0.007). Chemotherapy and radiation costs remained stable or increased for most stage and histology groups, ranging from $4242 to $8287 per month during the initial six months of care. Costs during the final six months of life decreased for those who died of lung cancer or other causes.

Conclusions: Cost-effectiveness analyses of lung cancer control interventions in the United States have been using outdated and incomplete treatment cost estimates. Our cost estimates enable updated cost-effectiveness analyses to determine the benefit of lung cancer control from a health economics point of view.

Keywords: SEER-Medicare; healthcare costs; lung cancer; phase of care; treatment.

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Figures

Figure 1
Figure 1
Average monthly cancer‐attributable costs are presented for the initial phase, by treatment strategy. Costs ranged from $802 per month for patients who received surgery to $7469 per month for patients who received chemotherapy plus radiation
Figure 2
Figure 2
Average monthly cancer‐attributable costs are presented for the continuing phase, by treatment strategy. Costs ranged from $1100 per month for patients who received surgery to $4809 per month for patients who were treated with chemotherapy
See this image and copyright information in PMC

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