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Cost of cancer care for patients undergoing chemotherapy: The E lements of C ancer C are study
Author(s) -
Ward Robyn L,
Laaksonen Maarit A,
Gool Kees,
Pearson SallieAnne,
Daniels Ben,
Bastick Patricia,
Norman Richard,
Hou Changhao,
Haywood Philip,
Haas Marion
Publication year - 2015
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12354
Subject(s) - medicine , cancer , cohort , colorectal cancer , health care , medical prescription , lung cancer , chemotherapy , reimbursement , emergency medicine , oncology , nursing , economics , economic growth
Aim To determine the monthly treatment costs for each element of cancer care in patients receiving chemotherapy and to apportion the burden of cost by financing agent ( C ommonwealth, S tate government, private health insurer, patient). Methods A cohort of 478 patients (54% breast, 33% colorectal and 13% non‐small‐cell lung cancer) were recruited from 12 centers representing metropolitan and regional settings in public and private sectors. Primary data were linked to secondary data held in N ew S outh W ales state ( A dmitted P atients and E mergency D epartment D ata) and C ommonwealth ( M edicare and P harmaceutical B enefits) databases. The monthly treatment costs of each element of care and the funding agent were calculated from secondary health data. Results Across all tumor types, the mean monthly treatment cost was $4162 (10%–90% quantiles $1018–$8098; range $2853 [adjuvant colorectal] to $5622 [metastatic lung]), with 54% of this cost borne by C ommonwealth government, 26% by private health insurers, 14% by S tate government and 6% by patients. The mean monthly costs of treating metastatic disease were $1415 greater than those for adjuvant therapy. The mean monthly costs were contributed to by inpatient care ($1657, 40%), chemotherapy prescriptions ($1502, 36%), outpatient care ($452, 11%) and administration of chemotherapy ($364, 9%). Conclusion All four funders have a shared incentive to reduce absolute monthly treatment costs since their proportional contribution is relatively constant for most tumor types and stages. There are opportunities to reduce cancer care costs by minimizing the risk of inpatient hospital admissions that arise from chemotherapy administration and by recognizing incentives for cost‐shifting.