The Economic Burden of Cancer in the United States

2017 ◽  
Author(s):  
K. Robin Yabroff ◽  
Gery P. Guy ◽  
Matthew P. Banegas ◽  
Donatus U. Ekwueme
Keyword(s):  
United States ◽  
End Of Life ◽  
Economic Burden ◽  
Initial Period ◽  
Indirect Costs ◽  
The United States ◽  
Use Of Resources ◽  
Initial Care ◽  
Pain And Suffering ◽  
Care Costs

With an aging and growing population and improved early detection and survival following diagnosis in the United States, the number of cancer survivors and prevalence of survivorship are expected to increase. Based on population trends, national expenditures for cancer care are projected to increase from $124.6 billion in 2010 to $157.8 billion in 2020. This chapter describes the economic burden of cancer, including direct costs, resulting from the use of resources for medical care for cancer; indirect costs, resulting from the loss of economic resources and opportunities associated with morbidity and mortality due to cancer and its treatment; and psychosocial or intangible costs, such as pain and suffering. Consistent with the intensity of treatment for initial care, recurrence, and end-of-life care, costs are highest in the initial period following diagnosis and, among patients who die from their disease, at the end of life, following a U-shaped curve.

scholarly journals The projected economic and health burden of uncontrolled asthma in the United States

2019 ◽  
Author(s):  
Mohsen Yaghoubi ◽  
Amin Adibi ◽  
Abdollah Safari ◽  
J Mark FitzGerald ◽  
Mohsen Sadatsafavi ◽  
...  
Keyword(s):  
United States ◽  
Asthma Control ◽  
Economic Burden ◽  
Indirect Costs ◽  
State Level ◽  
The United States ◽  
Suboptimal Control ◽  
Asthma Prevalence ◽  
Uncontrolled Asthma ◽  
Life Years

AbstractRationaleDespite effective treatments, a large proportion of asthma patients do not achieve sustained asthma control. The ‘preventable’ burden associated with lack of proper control is likely taking a high toll at the population level.ObjectiveWe predicted the future health and economic burden of uncontrolled asthma among American adults for the next 20 years.MethodsWe built a probabilistic model that linked state-specific estimates of population growth, asthma prevalence rates, and distribution of asthma control levels. We conducted several meta-analyses to estimate the adjusted differences in healthcare resource use, quality-adjusted life years (QALYs), and productivity loss across control levels. We projected, nationally and at the state-level, total direct and indirect costs (in 2018 USD) and QALYs lost due to uncontrolled asthma from 2019 to 2038 in the United States.Measurements and Main ResultsOver the next 20 years, the total undiscounted direct costs associated with suboptimal asthma control will be $300.6 billion (95% confidence interval [CI] $190.1 – $411.1). When indirect costs are added, total economic burden will be $963.5 billion (95%CI $664.1 – $1,262.9). American adolescents and adults will lose 15.46 million (95%CI 12.77 million – 18.14 million) QALYs over this period due to suboptimal control of asthma. In state-level analysis, the average 20-year per-capita costs due to uncontrolled asthma ranged from $2,209 (Arkansas) to $6,132 (Connecticut).ConclusionThe burden of uncontrolled asthma will continue to grow for the next twenty years. Strategies towards better management of asthma may be associated with substantial return on investment.

HSR19-102: Direct and Indirect Economic Burden of Cervical Cancer (CxCa) in the United States in 2015: A Mixed-Methods Analysis

2019 ◽  
Vol 17 (3.5) ◽  
pp. HSR19-102
Author(s):  
Chizoba Nwankwo ◽  
Shelby L. Corman ◽  
Ruchit Shah ◽  
Youngmin Kwon
Keyword(s):  
United States ◽  
Mixed Methods ◽  
Economic Burden ◽  
Healthcare Costs ◽  
Indirect Costs ◽  
Early Death ◽  
The United States ◽  
Productivity Costs ◽  
Direct And Indirect Costs ◽  
Lost Productivity

Background: An estimated 12,820 women in the United States will be diagnosed with CxCa in 2018, with 4,210 deaths from the disease. The economic burden of CxCa, both in terms of healthcare costs and lost productivity, has not been adequately studied. Methods: This was a mixed-methods study that evaluated the direct and indirect costs of CxCa using data from the Medical Expenditure Panel Survey (MEPS) for prevalent CxCa cases and the National Center for Health Statistics (NCHS) for deaths due to CxCa. Total healthcare costs and number of work days missed were compared between CxCa cases and controls in MEPS, using propensity scores calculated from baseline demographics and comorbidities. Missed work was converted to costs using the average hourly wage for women in 2015. Per-patient incremental healthcare and lost work productivity costs were then multiplied by the number of prevalent cases of CxCa in 2015 obtained from the Surveillance, Epidemiology, and End Results Program (SEER). NCHS data on the age-stratified number of CxCa deaths per year (1935–2015) and life expectancy data from the Social Security Administration were then used to calcluate the number of women who would be alive in 2015 if they had not died from CxCa and the lost earnings resulting from early mortality. The primary study outcome was the total direct and indirect cost of CxCa in 2015, calculated as the sum of the incremental direct healthcare costs, incremental lost productivity costs due to missed work, and lost productivity costs resulting from early death due to CxCa. Results: An estimated 257,524 women were alive with CxCa in 2015. Total healthcare costs were $4,221 higher, and an additional 0.37 work days were missed in women with CxCa compared to propensity-matched controls. Of the 488,475 women who died of CxCa prior to 2015, 108,832 would be alive in 2015 and 38,540 would be part of the workforce. Lost earnings in 2015 attributable to these deaths totaled $2.19 billion. The total economic burden of CxCa in the United States in 2015 was thus estimated at $3.3 billion (Table 1). Conclusions: CxCa was responsible for nearly $3.3 billion in direct and indirect costs in 2015. Early death among women with CxCa was the biggest driver of total economic burden.

The Humanistic and Economic Burden of Pediatric Focal Seizures in the United States

2020 ◽  
Vol 35 (8) ◽  
pp. 543-555
Author(s):  
Sarah N. Gibbs ◽  
Jiyoon Choi ◽  
Ibrahim Khilfeh ◽  
K. Hamzah Ahmed ◽  
Irina Yermilov ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Medication Adherence ◽  
Health Care Costs ◽  
Economic Burden ◽  
Attention Deficit Disorder ◽  
The United States ◽  
Old Patients ◽  
Focal Seizures ◽  
Care Costs

Objective: To better understand the humanistic and economic burden of focal seizures in children 2-12 years old. Methods: We conducted a targeted literature review by searching MEDLINE for English-language publications reporting on children 2-12 years old with focal seizures published in the United States since 2008. Results: Thirty-five publications were included. Incidence of focal seizures was 23.2 to 47.1 per 100,000 children per year; prevalence was 2.0 per 1,000 children, and ranged from 1.6 - 2.6 per 1,000 in patients of any age. Life expectancy was 47.3-61.8 years among children 3-12 years old. Patients took several antiepileptic drugs and experienced frequent seizures, sleep disorders, mood disorders, migraine, and seizure-related injuries (eg, bone fractures, sprains, open wounds). Children with focal seizures scored below average on cognitive assessments and up to 42%, 16%, and 19% had depression, anxiety, and attention-deficit disorder, respectively. Patients of any age had about 10 outpatient visits (2 epilepsy-related), 2 inpatient visits (less than 1 epilepsy-related), and 24 procedures (1 epilepsy-related) per year. Medication adherence was low: only half of pediatric patients maintained ≥90% adherence over 6 months. Annual total health care costs among patients of any age ranged from $18,369 - 38,549; first-year total health care costs for children were $19,883. Conclusions: Incidence and prevalence of focal seizures is high and the humanistic and economic burdens are significant. Future studies focused exclusively on children with focal seizures are needed to more precisely describe the burden. We also suggest further research and implementation of methods to improve medication adherence as an approach to lessen burden on these young patients.

scholarly journals Economic Burden among Commercially Insured Patients with Systemic Sclerosis in the United States

2019 ◽  
Vol 46 (8) ◽  
pp. 920-927 ◽  
Author(s):  
Zhou Zhou ◽  
Yanni Fan ◽  
Wenxi Tang ◽  
Xinyue Liu ◽  
Darren Thomason ◽  
...  
Keyword(s):  
United States ◽  
Systemic Sclerosis ◽  
Economic Burden ◽  
Index Date ◽  
Indirect Costs ◽  
The United States ◽  
Healthcare Resource Utilization ◽  
Work Loss ◽  
Signed Rank ◽  
Rate Ratios

Objective.To quantify healthcare resource utilization (HRU), work loss, and annual direct and indirect healthcare costs among patients with systemic sclerosis (SSc) compared to matched controls in the United States.Methods.Data were obtained from a large US commercial claims database. Patients were ≥ 18 years old at the index date (first SSc diagnosis) and had ≥ 1 SSc diagnosis in the inpatient (IP) or emergency room (ER) setting, or ≥ 2 SSc diagnoses on 2 different dates in the outpatient (OP) setting between January 1, 2005, and March 31, 2015; continuous enrollment was required during the followup period (12 months after the index date). Individuals with no SSc diagnoses were matched 1:1 to patients with SSc. Wilcoxon signed-rank and McNemar tests were used for comparisons and regressions with generalized estimating equations for adjusted OR (aOR) and incidence rate ratios (IRR) between 2 cohorts.Results.There were 2192 pairs of patients with SSc and matched controls included (mean age 57.6 yrs; 84.3% female); of these, 233 were eligible for work loss/indirect cost analyses. Compared to matched controls, patients with SSc had significantly higher HRU and costs during the 1-year followup period, IP admissions (adjusted IRR = 2.4), IP hospitalization days (adjusted IRR = 3.1), ER visits (adjusted IRR = 2.0), OP visits (adjusted IRR = 2.3), and days of work loss (adjusted IRR = 2.6). The adjusted difference in annual direct and indirect costs was US$12,820 and $3103, respectively (all p < 0.0001).Conclusion.Patients with SSc had a high direct and indirect economic burden postdiagnosis.

scholarly journals A framework for assessing the lifetime economic burden of congenital cytomegalovirus in the United States

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Aaron Lucas ◽  
Anushua Sinha ◽  
Karen B. Fowler ◽  
Deirdre Mladsi ◽  
Christine Barnett ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Costs ◽  
Economic Burden ◽  
The United States ◽  
Congenital Cytomegalovirus ◽  
The Us ◽  
Data Gaps ◽  
Intangible Costs ◽  
Care Costs

Abstract Background In the United States (US), congenital cytomegalovirus infection (cCMVi) is a major cause of permanent disabilities and the most common etiology of non-genetic sensorineural hearing loss. Evaluations of prevention strategies will require estimates of the economic implications of cCMVi. We aimed to develop a conceptual framework to characterize the lifetime economic burden of cCMVi in the US and to use that framework to identify data gaps. Methods Direct health care, direct non-health care, indirect, and intangible costs associated with cCMVi were considered. An initial framework was constructed based on a targeted literature review, then validated and refined after consultation with experts. Published costs were identified and used to populate the framework. Data gaps were identified. Results The framework was constructed as a chance tree, categorizing clinical event occurrence to form patient profiles associated with distinct economic trajectories. The distribution and magnitude of costs varied by patient life stage, cCMVi diagnosis, severity of impairment, and developmental delays/disabilities. Published studies could not fully populate the framework. The literature best characterized direct health care costs associated with the birth period. Gaps existed for direct non-health care, indirect, and intangible costs, as well as health care costs associated with adult patients and those severely impaired. Conclusions Data gaps exist concerning the lifetime economic burden of cCMVi in the US. The conceptual framework provides the basis for a research agenda to address these gaps. Understanding the full lifetime economic burden of cCMVi would inform clinicians, researchers, and policymakers, when assessing the value of cCMVi interventions.

scholarly journals Economic Burden of Periodontal Disease in Europe and the United States of America – An updated forecast

2021 ◽  
Author(s):  
João Botelho ◽  
Luís Proença ◽  
Yago Leira ◽  
Leandro Chambrone ◽  
José João Mendes ◽  
...  
Keyword(s):  
United States ◽  
Periodontal Disease ◽  
Economic Burden ◽  
United States Of America ◽  
Periodontal Diseases ◽  
Indirect Costs ◽  
The United States ◽  
European Countries ◽  
Life Years ◽  
The Usa

AbstractIntroductionPeriodontal disease is a pandemic condition and its severe form affects approximately 10% of the global population. Here, we present a forecast for the economic burden of periodontal disease in 32 European countries and in the United States of America (USA).Material and methodsIn an aggregate population-based cost analysis, taken as reference the most recent available data, we estimated the cost of periodontal disease. Under this, global health, dental and periodontal expenditures were estimated. Additionally, indirect estimates accounted for Disability-Adjusted Life Years (DALY) valued at per capita Gross Domestic Product (GDP), to estimate productivity losses, including periodontal disease, edentulism due to periodontal disease and caries due to periodontal disease.ResultsIn 2018 the aggregate cost in Europe was estimated at €17.00B and €2.35B more in the USA (€19.35B). Indirect costs due to periodontal disease amounted to €132.52B in European countries and €103.30B in the USA. The majority of the projected indirect costs were due to edentulism related to periodontal disease and periodontal disease. Indirect costs were the major portion of the estimated economic impact with an average of 0.66% of GDP in Europe and 0.50% in the USA. For the overall costs (direct and indirect), the value amounted to 0.75% of GDP in Europe and 0.60% in the USA.ConclusionPeriodontal disease caused a €149.52B loss in Europe and €122.65B in the USA, in 2018. These results show that the economic burden of periodontal disease is increasing.CLINICAL RELEVANCEScientific rationale for the studyConsidering the pandemic pattern of periodontal diseases we present a forecast for the economic burden of periodontal disease in 32 European countries and in the United States of America (USA).Principal findingsPeriodontal disease caused a €149.52B loss in Europe and €122.65B in the USA, in 2018. For the overall costs (direct and indirect), the value amounted to 0.75% of GDP in Europe and 0.60% in the USA.Practical implicationsThese results show that the economic burden of periodontal disease is increasing.

scholarly journals Clinical, humanistic, and economic burden of severe hemophilia B in the United States: Results from the CHESS US and CHESS US+ population surveys

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Tom Burke ◽  
Sohaib Asghar ◽  
Jamie O’Hara ◽  
Eileen K. Sawyer ◽  
Nanxin Li
Keyword(s):  
United States ◽  
Economic Burden ◽  
Indirect Costs ◽  
The United States ◽  
Factor Ix ◽  
Hemophilia B ◽  
Patient Records ◽  
Severe Hemophilia ◽  
The Us ◽  
The Mean

Abstract Background Hemophilia B is a rare congenital bleeding disorder that has a significant negative impact on patients’ functionality and health-related quality of life. The standard of care for severe hemophilia B in the United States is prophylactic factor IX replacement therapy, which incurs substantial costs for this lifelong condition. Accurate estimates of the burden of hemophilia B are important for population health management and policy decisions, but have only recently accounted for current management strategies. The ‘Cost of Severe Hemophilia across the US: a Socioeconomic Survey’ (CHESS US) is a cross-sectional database of medical record abstractions and physician-reported information, completed by hematologists and care providers. CHESS US+ is a complementary database of completed questionnaires from patients with hemophilia. Together, CHESS US and CHESS US+ provide contemporary, comprehensive information on the burden of severe hemophilia from the provider and patient perspectives. We used the CHESS US and CHESS US+ data to analyze the clinical, humanistic, and economic burden of hemophilia B for patients treated with factor IX prophylaxis between 2017 and 2019 in the US. Results We conducted analysis to assess clinical burden and direct medical costs from 44 patient records in CHESS US, and of direct non-medical costs, indirect costs, and humanistic burden (using the EQ-5D-5L) from 57 patients in CHESS US+. The mean annual bleed rate was 1.73 (standard deviation, 1.39); approximately 9% of patients experienced a bleed-related hospitalization during the 12-month study period. Nearly all patients (85%) reported chronic pain, and the mean EQ-5D-5L utility value was 0.76 (0.24). The mean annual direct medical cost was $614,886, driven by factor IX treatment (mean annual cost, $611,971). Subgroup analyses showed mean annual costs of $397,491 and $788,491 for standard and extended half-life factor IX treatment, respectively. The mean annual non-medical direct costs and indirect costs of hemophilia B were $2,371 and $6,931. Conclusions This analysis of patient records and patient-reported outcomes from CHESS US and CHESS US+ provides updated information on the considerable clinical, humanistic, and economic burden of hemophilia B in the US. Substantial unmet needs remain to improve patient care with sustainable population health strategies.

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