Rising Economic Burden of Renal Cell Carcinoma among Elderly Patients in the USA: Part II-An Updated Analysis of SEER-Medicare Data.

Abstract

The influx of new oncologic technologies has changed the treatment landscape of renal cell carcincoma (RCC) in the last decade. This study updated a previously published paper on the economic burden of RCC in the USA by using more recent data to examine the impact of various forms of new oncologic technologies on the economic burden of RCC. Using the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we employed prevalence and incidence costing approaches to estimate RCC costs from the payer's perspective. We conducted a longitudinal analysis of cost data per patient per month for a prevalence cohort of patients with RCC to determine which category of new technology (surgery, radiation, or cancer drugs) was the major cost driver for RCC. We then applied the incidence costing approach to estimate costs related to RCC by care phase (initial, continuing, and terminal) and compared costs between two incidence cohorts to examine how new technology affected the economic burden of RCC over time. After controlling for demographic factors, clinical characteristics, neighborhood socioeconomic status, and time trend, we found that rising per patient per month costs were driven by new technologies in cancer drugs. Incidence-based analysis showed the annual net cost (2018 US$) for patients with distant-stage RCC diagnosed between 2002 and 2006 was $51,639, $19,025, $76,603, and $29,045 for the initial, continuing (year 1), terminal (died from RCC), and terminal (died from other causes) care phases, respectively. Costs increased to $70,703, $34,716, $107,989, and $47,538, respectively, for the incidence cohort diagnosed between 2007 and 2011. The rising economic burden of RCC was most pronounced among patients with distant-stage RCC, and driven primarily by new cancer drugs.