Although cancer care costs are rising, it is proportional to the total utilization of healthcare resources and spending growth is happening more in areas that have seen innovation, explained Debra Patt, MD, MPH, MBA, director of public policy at Texas Oncology.
Although cancer care costs are rising, it is proportional to the total utilization of healthcare resources and spending growth is happening more in areas that have seen innovation, explained Debra Patt, MD, MPH, MBA, director of public policy at Texas Oncology.
Transcript (slightly modified)
What are the major contributors to the high cost of cancer care?
So cancer care is expensive and as new therapies have been developed and approved it’s gotten more expensive over time. Some of those therapies contribute greatly to progression-free survival and overall survival; and so when we did the study with Milliman, looking at total cost of care through the Truven MarketScan Database, which is a commercial database and the Medicare 5% population, we looked over an 11-year period and we saw that during that time total costs of cancer care did rise, but at a rate that was proportional to total healthcare resource utilization. So for actively-treated cancer patients, for patients with a history of cancer, and for the total population, there was proportional growth. So it wasn’t disproportionate.
Then we looked at the second part, which was to look at categorical healthcare resource utilizations—so for actively-treated cancer patients, the per-patient per-year costs—to look at percentage spends in different categories, things like surgeries, and hospitalizations, and chemotherapy, and biologics. What we did see is there has been growth in chemotherapy and biologic therapy over that 11-year period in both the Medicare database and in the commercial population. I think this is representative of what we see today, but I would say that growth proportionally was a small percentage of change, and there were other decreases in percentage spending and hospitalizations.
When we looked by disease type to understand why this categorical change is occurring, we could see that there were certain diseases where healthcare resource utilization had increased more. So for example, blood disorders, breast in the commercial population, prostate in the commercial population. Those were diseases that had grown more than average spending. And if we look historically to why that might happen, we know that there are innovations in those specific disease states that have occurred over the last 11 years.
So for example, in myeloma I know that in 2006, when I graduated fellowship, we would tell people with a new diagnosis of multiple myeloma that they had an average survival of about 3 years. Today I don’t say that. Because today I know that, on average, their survival is certainly over 6 years, and it continues to improve as a response to that innovation.
Joanne Mizell: Lifestyle Modification Programs Take Holistic Aim at Metabolic Disease
May 1st 2024Joanne Mizell shares insurer strategies in addressing the escalating rates of metabolic diseases, highlighting the importance of holistic treatment methods like lifestyle modification programs, which integrate nutrition, physical activity, and community engagement.
Read More
Tackling Health Inequality: The Power of Education and Experience
April 30th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.
Listen
BRCA-Like Classification May Be a Useful Biomarker for Olaparib Response in Ovarian Cancer
May 1st 2024Adding olaparib to maintenance therapy with bevacizumab was associated with significantly longer survival for patients with ovarian cancer whose tumors have a BRCA-like genomic profile, but not among those with non-BRCA-like tumors, a study found.
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
The Federal Trade Commission (FTC) issued letters to 10 companies to warn them that certain drug patents were improperly listed; the US Department of Agriculture (USDA) will begin testing ground beef for bird flu particles; rural Americans are more likely to die early from 1 of the 5 leading causes of death than those who live in urban areas.
Read More