A surprising new analysis finds the cost of treating cancer has nearly doubled over the past two decades and the amount of costs picked up by insurance companies and Medicaid have increased. But not everyone agrees with the analysis.
Cutting-edge technology and pricey drugs might seem like key reasons for the dramatic cost increase, but according to the analysis published online in CANCER the peer-review journal of the American Cancer Society, the shear number of newly-diagnosed cancer cases plays a larger role.
Researchers at the Centers for Disease Control and Prevention (CDC) compared medical costs of cancer treatment during the late 1980s to those same expenses from 2001 to 2005.
Florence Tangka of the CDC, the analysis’ lead author said the U.S. population is aging and older people tend of get cancer at a higher rate.
Overall, they found the cost of treating cancer, when adjusted for inflation, went from $24.7 billion in 1987 to $48.1 billion in 2005.
As of 2005, insurers picked up the tab for about half of all cancer treatment costs, compared to 42 percent in 1987, the study said. Medicare picked up 34 percent of payments compared to 33 percent in 1987. Medicaid payments tripled to 3 percent.
However two funding sources paid less in 2005, according to the study. Out-of-pocket costs went down from 17 percent to 8 percent, and other public sources declined by 2 percent.
The findings may not tell the whole story. One-in-four cancer patients or their families used up all or most of their savings paying for treatment, according to a 2006 survey by USA TODAY, the Kaiser Family Foundation and the Harvard School of Public Health.
John Seffrin, American Cancer Society chief executive officer agrees. “Growing numbers of people simply can't afford to get the care we know they need,” he says. "We hear about a growing number of people turning down treatment altogether due to cost.”
The analysis revealed much of the cost of treating cancer patients have shifted away from inpatient treatments to outpatient care. The shift to outpatient care has apparently helped blunt the increase cost of some treatments, including pricey drugs.
The analysis found that cancer care requires fewer patients to be hospitalized, so the share of inpatient hospital admissions fell from 64.4 percent in 1987 to 27.5 percent in 2001-2005. The change meant actual spending on inpatient care dropped to $13.2 billion from $15.9 billion (in constant dollars).
However, Dr. Len Lichtenfeld, deputy chief medical officer with the American Cancer Society, told USA TODAY that the costs might have been substantially higher if the surveys were done today because so many expensive treatments have recently become available. One example is the newly approved prostate cancer drug Provenge, which is expected to cost $93,000 per patient. Studies show that doctors who are "generously" reimbursed tend to prescribe more costly therapies.
Another analysis published in March Journal of the American Medical Association (JAMA) agrees that the number of people diagnosed with cancer is climbing, but also found the cost of cancer treatment is “skyrocketing” for individual patients and the nation. The financial burden of cancer is estimated in the JAMA analysis to have cost $90 billion in 2008, and was driven by the rising cost of sophisticated new drugs, robotic surgeries and radiation techniques, as well as the growing number of patients who are now eligible to receive them.
In the past, older and frail cancer patients may have been passed over for traditional surgical options, but today the same patients have options for less invasive surgeries and tightly-focused radiation therapies. New drugs are now available to “calm” the horrible side effects often experienced by patients undergoing chemotherapy, such as nausea, but they come with a significant financial cost for many patients.
Lynette Summerill is an award-winning writer who lives in Scottsdale, Arizona. In addition to writing about cancer-related issues, she writes a blog, Nonsmoking Nation, which follows global tobacco news and events.
Sources:
Cancer treatment cost in the United States: has the burden shifted over time?" Florence K. Tangka, Justin G. Trogdon, Lisa C. Richardson, David Howard, Susan A. Sabatino, and Eric A. Finkelstein. CANCER; Published Online: May 10, 2010.
Cancer's Next Frontier: Addressing High and Increasing Costs. Elena B. Elkin, PhD; Peter B. Bach, MD, MAPP. JAMA. 2010; 303(11):1086-1087.