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Costs of cancer care in children and adolescents in Ontario, Canada
Author(s) -
Oliveira Claire,
Bremner Karen E.,
Liu Ning,
Greenberg Mark L.,
Nathan Paul C.,
McBride Mary L.,
Krahn Murray D.
Publication year - 2017
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26628
Subject(s) - medicine , survivorship curve , cancer , public health , pediatrics , demography , population , health care , childhood cancer , gerontology , environmental health , nursing , sociology , economics , economic growth
Background Cancer in children and adolescents presents unique issues regarding treatment and survivorship, but few studies have measured economic burden. We estimated health care costs by phase of cancer care, from the public payer perspective, in population‐based cohorts. Methods Children newly diagnosed at ages 0 days–14.9 years and adolescents newly diagnosed at 15–19.9 years, from January 1, 1995 to June 30, 2010, were identified from Ontario cancer registries, and each matched to three noncancer controls. Data were linked with administrative records describing resource use for cancer and other health care. Total and net (patients minus controls) resource‐specific costs ($CAD2012) were estimated using generalized estimating equations for four phases of care: prediagnosis (60 days), initial (360 days), continuing (variable), final (360 days). Results Mean ages at diagnosis were 6 years for children (N = 4,606) and 17 years for adolescents (N = 2,443). Mean net prediagnosis phase 60‐day costs were $6,177 for children and $1,018 for adolescents. Costs for initial, continuing, and final phases were $138,161, $15,756, and $316,303 per 360 days for children, and $62,919, $7,071, and $242,008 for adolescents. The highest initial phase costs were for leukemia patients ($156,225 per 360 days for children and $171,275 for adolescents). The final phase was the most costly ($316,303 per 360 days for children and $242,008 for adolescents). Conclusions Costs for children with cancer are much higher than for adolescents and much higher than those reported in adults. Comprehensive population‐based long‐term estimates of cancer costs are useful for health services planning and cost‐effectiveness analysis.