April 29, 2008

Medicare Costs Soar for Cancer Care

TUESDAY, April 29 (HealthDay News) -- Treating elderly cancer patients for five years costs Medicare $21.1 billion, and these costs are expected to increase dramatically as the population ages, a new study says.

The costs for treating patients varies by type of cancer, with expenditures highest for lung, colorectal and prostate tumors, said the researchers, who based their estimates on patients diagnosed with cancer in 2004.

"Because the U.S. population is aging and growing, we think that these costs are going to get higher in the future," said lead researcher Robin Yabroff, an epidemiologist at the U.S. National Cancer Institute. "We think there are going to be a lot more cancer patients in the future."

"The main goal of this study," Yabroff added, "was to provide cost of care estimates that could be useful for policy makers and health planners and researchers that might want to do cost-effectiveness analyses."

The findings are published in the April 29 issue of the Journal of the National Cancer Institute.

For the study, Yabroff's team estimated the cost of cancer care among 718,907 cancer patients and compared that to 1,623,651 people without cancer. The researchers used data from the Surveillance, Epidemiology, and End Results (SEER) and SEER-linked Medicare files to identify these patients.

The researchers then subtracted Medicare costs for people without cancer from costs among those with cancer. The resulting number was the estimated cost of cancer care per person.

Costs varied over five years from about $20,000 for people with breast cancer or melanoma to $40,000 for people with lymphoma, brain or other cancers of the nervous system, as well as malignancies of the esophagus, ovaries or stomach.

The study authors found that costs were highest during the first year of treatment and also during the last year of life. Patients are more likely to be hospitalized during the last year of life, which increases costs, Yabroff said.

"We also found the cost of care is generally higher for patients diagnosed with a later stage disease, compared with patients diagnosed with earlier stage disease," Yabroff said.

To help contain costs, Yabroff suggested that more emphasis be placed on cancer screening and early diagnosis, as well as lifestyle changes, such as not smoking.

Paul Precht, policy director at the Medicare Rights Center, said he thinks Medicare will have to change some of its policies to keep costs down while continuing to offer care to the elderly with cancer.

"Clearly, treatment of cancer is expensive," he said. "When people talk about the sustainability of Medicare, they have to look at findings like this, because we are paying for treatments of very serious diseases, and that's why it's so expensive."

Precht agreed that one way to lower costs is to put more emphasis on early detection and increase Medicare benefits for prevention. Also, federal law needs to be changed to allow Medicare to negotiate drug prices with the pharmaceutical companies, he said.

"The cost of cancer drugs is going through the roof," he said. "Medicare really has to look at ways to deal with that."

People are already paying high co-payments and coinsurance for care under Medicare, and these costs are likely to grow, Precht added. And as those costs increase, it could reach a breaking point. "People will say: 'Yes, I want to live, but I don't have the money, so I guess I'm not going to,' and that's not right," he said.

Increasing costs don't necessarily lead to the rationing of health care, Precht said. "But there needs to be cost-effectiveness analysis, so there is some relationship to the effectiveness of the treatment we are paying for," he said.

More information

To learn about financial assistance and other resources for people with cancer, visit the U.S. National Cancer Institute.

SOURCES: Robin Yabroff, Ph.D., epidemiologist, U.S. National Cancer Institute, Bethesda, Md.; Paul Precht, policy director, Medicare Rights Center, Washington, D.C.; April 29, 2008, Journal of the National Cancer Institute
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