The cost of treating acute myeloid leukemia (AML) and other cancers in the United States is projected to increase substantially by 2030, a study reports.
The study, “Medical Care Costs Associated with Cancer Survivorship in the United States,” was published in Cancer Epidemiology, Biomarkers & Prevention.
The cost of treating cancer has risen continuously in the U.S. Previous analyses predicted that, in the decade from 2010 to 2020, the overall cost of cancer treatment would rise by about 27% (from $124.6 billion to $157.8 billion in 2010 dollars).
More recent analyses of actual trends suggest that cancer treatment costs, in 2019 dollars, would likely exceeded this prediction, arriving around 34% higher.
“Rising health care expenditures are a burden for patients, and costs of cancer care has become a critical topic in patient-provider discussions to facilitate informed decision-making,” Angela Mariotto, PhD, a study co-author with the National Cancer Institute, said in a press release. “Studies quantifying and projecting costs can further facilitate those discussions.”
Researchers used national databases to identify people age 65 or older who were diagnosed with cancer between 2000 and 2012, and used insurance claims information from 2007 to 2013 to estimate the cost of their cancer-related care. Of note, the analysis included both insurance-covered costs and costs for which the patient is directly responsible “to represent the costs of care,” the researchers wrote.
Costs were analyzed according to three phases of treatment: an initial phase (the first year of treatment), end-of-life care (EOL; the year before a patient’s death), and a continuing phase (everything in between).
Overall, average annual estimated cancer-related costs for these three phases were $42,000 for the initial phase, $5,000 for the continuing phase, and $105,000 for the EOL phase, with all in 2019 dollar values. For AML specifically, these values were $182,900, $21,000, and $239,400, respectively. AML had the highest initial and EOL costs of any cancer type.
In general, cancer treatment costs were higher for people diagnosed with more advanced disease.
For comparison, EOL costs were also estimated for controls (people who died of disorders other than cancer). EOL costs overall were significantly higher for cancer patients than for others ($105,000 vs. $23,500), and for AML specifically ($239,400 vs. $144,400).
“In this study, we found that the costs in the end-of-life phase of care were higher than those in the initial phase of care, and costs were highest among those initially diagnosed with advanced disease,” said Robin Yabroff, PhD, a study co-author with the American Cancer Society. “These results suggest that further research is needed to better understand the value and appropriateness of treatment intensity, especially among patients with advanced disease.
“There is also a need to ensure that expected costs of care are included in patient-provider discussions about treatment options, and that informed decisions can be made that fully reflect patients’ preferences,” Yabroff said.
Using these numbers, the researchers estimated how costs will increase from 2015 to 2030, based on how the population is expected to change in that time (i.e., the number of older people likely to develop cancer). They estimated that the total national cost of cancer treatment would increase by 34%.
The total national cost of treating leukemia, specifically, is expected to increase by 49% (from $8.7 billion to $13 billion).
“In summary,” the researchers concluded, “the national medical care costs associated with cancer survivorship in the United States in 2015 are substantial and projected to increase dramatically by 2030, due to population changes alone.”
This analysis has some limitations. For instance, the models used did not take into account the development of new therapies, which may affect treatment costs. The analysis also focused on people older than 65, and as such, its results “cannot be directly applied to the population of cancer survivors younger than 65 years,” the researchers wrote.
Nonetheless, the results may be helpful for informing discussions about cost of care, both nationally and among individuals.
“Patient-provider discussions about treatment options should include not only expected survival, quality of life implications, and potential adverse events, but also expected costs of care for different treatments,” Yabroff said. “For patients with cancer who are working, these discussions should address how treatment affects the ability to work, especially if the patient’s health insurance coverage is through their employer.”