Estimating the economic burden of gastric cancer in the United States.

Abstract

e16589 Background: Gastric cancer is a worldwide problem; however, there is little information regarding its economic burden in the US. Our primary objective was to estimate real-world resource use and cost associated with gastric cancer in a US managed care setting. Methods: Retrospective cohort analysis of direct costs and healthcare services use in gastric cancer patients and controls was conducted using IMS LifeLink Health Plan Claims (US) Database. Cases were patients ≥ 18 years of age and newly-diagnosed with gastric cancer in 2007-2009 (date of first gastric cancer diagnosis considered index date). Cases were excluded if they had evidence of any cancer in the 360 days prior to index or evidence of cancer other than gastric in the 4 weeks after index. Controls were individuals without gastric cancer and matched 1:1 with cases (98.4%) on age, gender, region, health plan and payer type, and length of follow-up. Health resource utilization and costs were reported as monthly means. Results: A total of 303 cases were identified and matched to a control. In both groups, mean age was 58, 55% were male and median follow-up was 364 days. Mean monthly costs for hospitalizations, emergency room visits, physician office visits, laboratory and radiology procedures, and pharmacy services were all significantly higher for cases than controls (p<0.0001). Total mean monthly costs were $10,653 for cases and $571 for controls. 75% of cases were hospitalized during follow-up vs. 9% of controls (p<0.0001) and mean monthly cost of hospitalizations was 35 times higher for cases than controls ($6,511 vs. $182). 92% of cases incurred a radiology procedure vs. 53% of controls (p<0.0001) and mean monthly cost of radiology procedures was 24 times higher for cases than controls ($997 vs. $41). Mean monthly drug cost for cases was $1,083 vs. $115 for controls. Conclusions: The mean total monthly healthcare cost for newly-diagnosed gastric cancer patients was 18 times higher than that of similar plan enrollees without gastric cancer. The largest difference was in inpatient costs, followed by drug and radiology costs. Although gastric cancer is less prevalent in the US, on a per patient basis, this disease appears to be associated with significant costs.