The Executive Suite: Cancer care costs U.S. $156.2 billion

Thursday, October 7, 2021

Cancer care costs U.S. $156.2 billion – mostly in drug expenses

Penn State College of Medicine researchers have found that the 15 most prevalent types of cancer in the U.S. cost approximately $156.2 billion in 2018, with medication being the biggest expense for breast, lung, lymphoma, and colorectal cancers.

The researchers examined a database that included statistics on cancer care for the 402,115 privately insured cancer patients younger than 65 in the U.S. The aim of the study was to gather this data to help understand how money is being spent on cancer care, which has traditionally been difficult to track, mainly because the U.S. has different ways to cover health care costs, such as private insurance for people less than 65 years of age and Medicare for people aged 65 and over.

"Cancer is a leading cause of death, actually overtaking heart disease as the leading cause of death in the U.S. over the past few years,” said Nicholas Zaorsky, assistant professor from the Departments of Radiation Oncology and Public Health Sciences at the College of Medicine and researcher at Penn State Cancer Institute, in a statement. “But, it's still unknown what we pay for in cancer care. As a team, we wanted to look at what private insurances are paying for each kind of cancer and for each type of service."

The researchers said that the database included 38.4 million types of CPT codes for the 15 cancers, which include breast, prostrate, colorectal, lung, lymphoma, melanoma, uterus, head and neck, bladder, kidney, thyroid, stomach, liver, pancreas, and esophagus cancers. The cohort study used 2018 data -- the most recent complete numbers available -- from the IBM Watson Health MarketScan. The sample included 27.1 million privately insured individuals, including patients diagnosed with the most prevalent cancers.

Breast cancer incurred the most services, about 10.9 million services and procedures, followed by colorectal cancer, which had approximately 3.9 million services listed in the database. Breast cancer was also the most expensive type of cancer, costing a total of $3.4 billion, followed by lung cancer and colorectal cancer, which were both estimated to incur around $1.1 billion in costs.

Drug costs represent the most expensive category for treating cancer patients, with about $4 billion spent on drugs to treat cancer, which is double the $2 billion paid out for surgeries.

The researchers said these figures show you how much the medical system spends on certain types of cancers versus another one, but not if these costs are justified. For example, pancreatic cancer is one of the deadliest cancers, but the total cost of care devoted to pancreatic cancer is relatively low versus indolent prostate cancer.