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Prostate cancer

Cost of Cancer Care Growing for Those With Private Insurance

The cost of cancer treatment is rising, and this is compounded by greater cost sharing and increasing out-of-pocket expenses for nonelderly adults with private insurance, according to a recent study published in the Journal of the National Cancer Institute

“Our study provides new evidence of the growing financial burden for cancer patients,” the researchers wrote. “This trend is consistent with the rising health-related financial burden among the privately insured in the general population.”

The researchers established cohorts of patients diagnosed with breast (n=105,255), colorectal (n=23,571), lung (n=11,321), and prostate (n=59,197) cancer from 2009 to 2016 using claims data from the Health Care Cost Institute. Information on cancer-related surgery, intravenous systemic therapy, and radiation therapy was included to calculate total and out-of-pocket costs. 


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From 2009 to 2016, the total mean cost per patient increased from $109,544 to $140,732 for breast cancer, reflecting a 29% increase. For lung cancer, the total mean cost increased from $151,751 to $168,730, reflecting an 11% increase. For prostate cancer, the total mean cost increased from $53,300 to $55,497, reflecting a 4% increase. The increase in cost for colorectal cancer was not statistically significant. 

Out-of-pocket costs increased to more than $6000 by 2016, reflecting an increase of more than 15% for all of the cancers evaluated. The use of intravenous systemic therapy and radiation therapy for the treatment of breast, prostate, and colorectal cancer was noted to have significantly increased. 

“We observed a trend of decreasing cost of IV systemic therapy for [colorectal cancer] and radiation for [prostate cancer],” the researchers wrote. “Both trends indicate pricing and reimbursement policies can be effective tools to curb the costs of cancer care. For [colorectal cancer], a major contributor for cost reduction in IV systemic therapy was a generic entry of 2 commonly used chemotherapy agents, oxaliplatin and irinotecan, following their patent expiration in 2007 and 2013, respectively.”

Additionally, the volume of surgical procedures performed was noted to have significantly increased among patients with breast or colorectal cancer, with approximately 90% of patients undergoing surgical intervention. The increased use of surgery reflects an often more aggressive approach to cancer in younger patients, according to the researchers.

“The growing prevalence of high-deductible plans and the rising cost-sharing requirements in private insurance plans will continue to exert financial burden. This trend calls for regulations to insurance benefit design,” the researchers wrote. “Ultimately, a meaningful reduction in cancer-related financial burden can only be achieved through initiatives that contain rising costs of cancer care on multiple fronts.”

Disclosures: The study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Shih Y-C T, Xu Y, Bradley C, et al. Costs around the first year of diagnosis for 4 common cancers among the privately insured. J Natl Cancer Inst. Published online September 13, 2022. doi:10.1093/jnci/djac141

This article originally appeared on Cancer Therapy Advisor