PHS138 - Colorectal Cancer (CRC) costs in the us: findings from the Medical Expenditure Panel Survey 2008-2012

Abstract

To estimate colorectal cancer (CRC) -attributable cost in the United States by quantifying the direct medical cost of cancer care for CRC patients and to study the effects of CRC on direct healthcare costs. We used direct medical cost data from the household component of the Medical Expenditure Panel Surveys (MEPS) of 2008 to 2012that gather healthcare utilization and expenditures for the US civilian non-institutionalized population. To estimate CRC-attributable cost, patients reporting a past CRC diagnosis were matched with non-cancer controls on age, region, poverty level, race, insurance status, and marital status. Generalized linear model (GLM) was chosen to model costs. An average of 110 persons in each year reported a prior CRC diagnosis.The mean annual direct medical cost attributable to CRC was $18,240 in 2008, $18,211 in 2009, $11,192 in 2010, $11,113 in 2011 and $13,301 in 2012. Applying the findings to SEER estimates of population-wide CRC prevalence, CRC attributable costs were $27.59 billion in 2008, $25.45 billion in 2009, $14.11 billion in 2010, $13.03 billion in 2011 and $15.08 billion in 2012, a trend consistent with the documented overall healthcare cost decline following the 2008-09 recession. Our study revealed a significant decline in annual CRC attributable cost in 2010. Our findings may be confounded by 5-plus year survivors who may no longer qualify as “cancer” patients, and by stage at diagnosis among the study sample. Localized disease is associated with a 90% 5-year survival rate. Study limitations include: a) a lack of consistent data on time since cancer diagnosis which is relevant to cancer care cost computations, and, b) lack of data on stage at diagnosis. With about 130,000 new cases each year, additional research is warranted to develop accurate cost estimates.