A population-level comparison of cancer-related and non-cancer-related health care costs using publicly available provincial administrative data

Abstract

Introduction: Costs associated with cancer care are increasing. Cancer costs in the context of other common non-cancer diagnoses have not been extensively studied at the population level. Knowledge from such analyses can inform health care resource allocation and highlight strategies to reduce overall costs.

Methods: Using cross-sectional data from publicly available population-level administrative data sources (health insurance claims, physician billing, and hospital discharge abstracts), we calculated incidence-adjusted health care costs (in 2014 Canadian dollars) for cancers and common non-cancer diagnoses in the adult population in a large Canadian province. Subgroup analyses were also performed for various provincial health administrative regions.

Results: Total costs related to cancer care amounted to $495 million for the province, of which at least $67 million (14%) was attributable to radiation and chemotherapy. Of the various cancer subtypes, hematologic malignancies were most costly at $70 million, accounting for 14% of the total cancer budget. Colon cancer followed at $51 million (10%), and lung cancer, at $44 million (9%). Cancer costs (with and without costs for radiation and chemotherapy) exceeded those for cardiovascular disease, diabetes mellitus, mental health, and trauma (p < 0.001). In addition, the costs of specific cancer subtypes varied by region, but hematologic and lung cancers were typically the most costly no matter the health region.

Conclusions: Using provincial administrative data to establish cost trends can help to inform health care allocation and budget decisions, and can facilitate comparisons between provinces.

Keywords: Cancer costs; administrative databases; health care costs; health economics.

FIGURE 1

Cancer diagnosis–specific and selected non-cancer diagnosis–specific costs by Alberta Health Services zone (2014 Canadian dollars). Costs of radiation and chemotherapy are excluded from the total cancer costs. CV = cardiovascular; DM = diabetes mellitus; MSK = musculoskeletal; MH = mental health.

FIGURE 2

Cancer subtype–specific costs by Alberta Health Services zone (2014 Canadian dollars).