How costly is brain cancer? Healthcare services use and costs from across the US

Abstract

1559 Background: Our research goal was to provide timely estimates of economic burden of brain cancer to the US healthcare system for patients (pts) across the US, and identify primary cost drivers. Methods: Retrospective cohort analysis of direct costs and healthcare services use in brain cancer pts and controls was conducted using MarketScan™ US employers' claims databases of over 3 million individuals. Cases were pts newly diagnosed with brain cancer in 1999–2000. Controls were individuals without cancer diagnosis and matched 3:1 with cases (97.5% match) on age, gender, healthcare coverage, region (e.g., West), and follow-up length. Utilization of healthcare services and costs were standardized to monthly means. Results: The study consisted of 652 cases and 1,959 controls. 40% of cases had late stage disease. Median age was 56 years for cases and 55 years for controls. Mean follow-up was 10.9 months for both groups. Mean monthly rates of hospitalizations, length of stay, emergency room visits, office visits, outpt radiology and laboratory procedures, and pharmacy-dispensed prescription drugs were all higher for cases than controls (p<0.0001). Cases had a 20 times higher monthly rate of hospitalization than controls (0.2 vs. 0.01). Mean monthly rate of office visits was 5.1 for cases vs. 0.8 for controls. Cases had more mean monthly prescription drugs than controls (3.4 vs. 1.1). Similarly, mean monthly total, inpt and outpt costs of cases were several times higher compared to controls (p<0.0001). Mean monthly total costs were $7,081 for cases and $237 for controls, hospitalizations accounted for $4,502 of the mean monthly total costs for cases and $58 for controls. Mean monthly costs associated with office visits were $1,501 for cases vs. $97 for controls. Conclusions: Pts with brain cancer accrued costs that were 23 times higher than demographically similar population without cancer. Office visits were the most frequent service; inpt costs were drivers of total costs. Despite its small incidence, the burden of brain cancer to the healthcare system is substantial and suggests a need for increased prevention or new therapies to impact resource use and healthcare costs. No significant financial relationships to disclose.