The rise in cancer treatment costs in combination with the increase of cost-sharing have financially burdened privately insured, nonelderly patients with cancer with increasing out-of-pocket (OOP) costs.

These findings were presented by Ya-Chen T. Shih, PhD, The University of Texas MD Anderson Cancer Center, Houston, TX, lead author of this study, at the 2021 ASCO Quality Care Symposium.

This study aimed to evaluate trends in treatment patterns and total and OOP costs of cancer care around the first year of diagnosis for privately insured, nonelderly patients with female breast, colorectal, lung, or prostate cancer.

A time period between 2 months before diagnosis and 12 months after diagnosis was used for this study. “The 14-month duration captures the most expensive care phase in the cost trajectory of cancer,” wrote Dr Shih and colleagues.

The Health Care Cost Institute’s claims data from 2009 to 2016 were used to form incident cohorts. Cancer-related surgeries, systemic therapies, radiation, and other hospitalizations were identified, and defined as "treatment modality.” Costs associated with treatment modality, and OOP costs (sum of deductible, coinsurance, and copayment) were calculated.

Health care utilization and cost trends (based on the year of diagnosis) in each of the 4 cancers were analyzed through logistic regressions and generalized linear models, respectively. Participants were categorized by cancer-type; 105,255 breast, 25,571 colorectal, 11,321 lung, and 59,197 prostate.

Systemic therapy and radiation use significantly increased between 2009 and 2016 in breast, colorectal, and prostate cancer, but not lung cancer. A significant increase in cancer surgeries was observed in patients with breast and colorectal cancer, while a decrease was observed in those with prostate cancer. Hospitalizations for reasons other than cancer declined across each cancer (P <.001). Treatment modality costs increased in all but systemic therapy for colorectal cancer and radiation for prostate cancer.

The increase in total mean costs per patient was 29% in breast cancer ($109,544 to $140,743), 11% in prostate cancer, and 4% in prostate cancer. There was no significant cost increase observed in colorectal cancer (P = .089). OOP costs increased by more than 15% across all cancers, with deductibles posing a significant financial burden.

“Rising costs of cancer treatments, compounded with increasing cost-sharing increased OOP costs for privately insured, non-elderly cancer patients,” concluded Dr Shih and colleagues, adding, “Policy initiatives to mitigate financial hardship should consider cost containment as well as insurance reform.”

Shih Y, Xu Y, Bradley C, et al. Trends in total and out-of-pocket cost of cancer care around the first year of diagnosis for the four most common cancers among privately insured nonelderly adults: 2009-2016. Presented at: the 2021 ASCO Quality Care Symposium; September 25-26, 2021; Boston, MA, and virtual; Abstract 5.