According to research from the National Cancer Institute published by Mariotto et al in Cancer Epidemiology, Biomarkers, and Prevention, the national cancer-attributable cost for medical services and prescription drugs is expected to increase from $183 billion in 2015 to $246 billion by 2030—an increase of 34%. The study found that overall medical costs were highest among those who died from cancer in the end-of-life phase, followed by those in the initial and continuing phases of medical care, including the costs of oral prescription drugs. In general, medical costs were highest for patients diagnosed with distant-stage disease.

A confluence of events in United States, including a growing number of people surviving cancer (there are currently nearly 17 million cancer survivors) an aging population, population growth, and the escalating price of cancer therapies, have accelerated the projected medical costs of cancer care over the next decade.

Study Methodology

The researchers identified cancer survivors aged 65 years and older diagnosed with cancer between 2000 and 2012 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. They then used claims from 2007 to 2013 to estimate costs by cancer site, phases of care, and stage of disease at diagnosis. Annualized average cancer-attributable costs for medical care (Medicare Parts A and B) and oral prescription drugs (Medicare Part D) were estimated by subtracting costs between patients with cancer and matched controls.

Costs were reported in 2019 U.S. dollars. The researchers combined phase-specific attributable costs with prevalence projections to estimate national costs from 2015 through 2030.

Study Results

The researchers found that the overall annualized average costs of medical care were highest in the end-of-life–cancer death phase, followed by the initial and continuing phases (medical care: $105,500, $41,800, and $5,300; oral prescription drugs: $4,200, $1,800, and $1,100, respectively). There was considerable variation in costs by cancer site and stage with annualized cancer-attributable medical costs in the end-of-life–cancer phase, ranging from $71,000 for patients with prostate cancer to $239,000 for patients with acute myeloid leukemia.

The cancer-attributable annualized average medical costs in the initial, continuing, and noncancer end-of-life phases were $41,800, $5,300, and $23,500 per patient, respectively.

Overall national costs in 2015 were $183 billion and projected to increase 34% to $246 billion by 2030, based only on population growth.

“Phase of care cancer-attributable cost estimates by cancer site and stage are key inputs for simulation models and cost-effectiveness analysis,” concluded the study authors.

Impact on Cancer Care

Angela B. Mariotto, PhD

“Rising health-care expenditures are a burden for patients, and costs of cancer care has become a critical topic in patient-provider discussions to facilitate informed decision-making,” said Angela B. Mariotto, PhD, Chief of the Data Analytics Branch at the National Cancer Institute, in a statement. “Studies quantifying and projecting costs can further facilitate those discussions. In addition, this type of research can help health policymakers better understand the issue of rising costs and can help health-care providers better plan resource allocation.”

Dr. Mariotto is the corresponding author of this study.

Disclosure: For full disclosures of the study authors, visit cebp.aacrjournals.org.