scholarly journals Medical expenditure for lung cancer in China: a multicenter, hospital-based retrospective survey

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xin Zhang ◽  
Ju-Fang Shi ◽  
Guo-Xiang Liu ◽  
Jian-Song Ren ◽  
Lan-Wei Guo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Care ◽  
Consumer Price Index ◽  
Medical Expenditures ◽  
Drug Costs ◽  
Medical Expenditure ◽  
Annual Growth Rate ◽  
Lung Cancer Patients ◽  
Expenditure Data ◽  
Nationally Representative

Abstract Background Lung cancer is the most prevalent cancer, and the leading cause of cancer-related deaths in China. The aim of this study was to estimate the direct medical expenditure incurred for lung cancer care and analyze the trend therein for the period 2002–2011 using nationally representative data in China Methods This study was based on 10-year, multicenter retrospective expenditure data collected from hospital records, covering 15,437 lung cancer patients from 13 provinces diagnosed during the period 2002–2011. All expenditure data were adjusted to 2011 to eliminate the effects of inflation using China’s annual consumer price index. Results The direct medical expenditure for lung cancer care (in 2011) was 39,015 CNY (US$6,041) per case, with an annual growth rate of 7.55% from 2002 to 2011. Drug costs were the highest proportionally in the total medical expenditure (54.27%), followed by treatment expenditure (14.32%) and surgical expenditure (8.10%). Medical expenditures for the disease varied based on region, hospital level, type, and stage. Conclusion The medical expenditure for lung cancer care is substantial in China. Drug costs and laboratory test are the main factors increasing medical costs.

An assessment of the total cost of pancreatic cancer using real-world evidence.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 773-773
Author(s):  
Vincent J. Picozzi ◽  
Victoria G. Manax ◽  
Kelly Feehan ◽  
Zachary Wintrob ◽  
Michele Korfin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pancreatic Cancer ◽  
Prescription Drug ◽  
Cancer Care ◽  
Drug Costs ◽  
Medical Expenditure ◽  
Total Cost ◽  
Patient Level ◽  
Second Year

773 Background: The aggregate health economic implications of pancreatic cancer are poorly understood, especially from the patient perspective. As a preliminary effort, we sought to better understand changes in type and quantity of medical expenditures over time, along with quality of life related costs, from this perspective. This preliminary research is part of a larger effort to understand how the introduction of new treatments affect both the outcome and costs of pancreatic cancer associated with care, patients, survivors, their families, and their communities. Methods: We analyzed patient-level data from the Medical Expenditure Panel Survey (MEPS, 1996- 2017). All analyses were performed using R version 3.6.1 on Ubuntu 19.04. Averages were computed for the total health care costs, including prescription drug costs. Average individual annual cost estimates for the second year excluded individuals that were identified as having died prior to the first round of data collection in the second year. The individual patient level ratios of prescription drug cost to other medical expenses was also computed. All expenditures are adjusted for inflation using 2017 US dollars. Included subjects, N= 80 had a diagnosis of pancreatic cancer and available prescription data. Individual age and employment status were accounted for as covariates. Results: Between 1997 and 2017 inflation adjusted first and second year non-medication spending on pancreatic cancer care averaged $66,999.96 and $105,308.60 respectively. However, inflation-adjusted first and second year charges for hospitalizations and emergency visits fell between 2007-2017. Prescription drug as a proportion of total spending prescription drugs increased during the same time period. Lost work/school days declined between 2007 and 2017. Conclusions: Total inflation adjusted pancreatic cancer care expenses declined over the past decade even as drug costs increased. Quality of life costs declined as well. Further analysis is needed to evaluate the relationship between drug spending, total cost of care and quality of life.

scholarly journals Lung cancer care trajectory at a Canadian centre: an evaluation of how wait times affect clinical outcomes

2017 ◽  
Vol 24 (5) ◽  
pp. 302 ◽  
Author(s):  
G. Kasymjanova ◽  
D. Small ◽  
V. Cohen ◽  
R.T. Jagoe ◽  
G. Batist ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Patient Outcomes ◽  
Cancer Care ◽  
Wait Time ◽  
Treatment Modalities ◽  
Wait Times ◽  
Model Of Care ◽  
Time Intervals ◽  
Lung Cancer Patients

Background Lung cancer continues to be one of the most common cancers in Canada, with approximately 28,400 new cases diagnosed each year. Although timely care can contribute substantially to quality of life for patients, it remains unclear whether it also improves patient outcomes. In this work, we used a set of quality indicators that aim to describe the quality of care in lung cancer patients. We assessed adherence with existing guidelines for timeliness of lung cancer care and concordance with existing standards of treatment, and we examined the association between timeliness of care and lung cancer survival.Methods Patients with lung cancer diagnosed between 2010 and 2015 were identified from the Pulmonary Division Lung Cancer Registry at our centre.Results We demonstrated that the interdisciplinary pulmonary oncology service successfully treated most of its patients within the recommended wait times. However, there is still work to be done to decrease variation in wait time. Our results demonstrate a significant association between wait time and survival, supporting the need for clinicians to optimize the patient care trajectory.Interpretation It would be helpful for Canadian clinicians treating patients with lung cancer to have wait time guidelines for all treatment modalities, together with standard definitions for all time intervals. Any reductions in wait times should be balanced against the need for thorough investigation before initiating treatment. We believe that our unique model of care leads to an acceleration of diagnostic steps. Avoiding any delay associated with referral to a medical oncologist for treatment could be an acceptable strategy with respect to reducing wait time.

scholarly journals Catastrophic health expenditure and its determinants in households with lung cancer patients in China: a retrospective cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng-yao Sun ◽  
Ju-fang Shi ◽  
Wen-qi Fu ◽  
Xin Zhang ◽  
Guo-xiang Liu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Screening Program ◽  
Average Distance ◽  
Catastrophic Health Expenditure ◽  
Urban China ◽  
Medical Expenditure ◽  
Vulnerable Groups ◽  
Lung Cancer Patients ◽  
The Impact

Abstract Background Numerous studies have examined catastrophic health expenditures (CHE) worldwide, mostly focusing on general or common chronic populations, rather than particularly vulnerable groups. This study assessed the medical expenditure and compensation of lung cancer, and explored the extent and influencing factors of CHE among households with lung cancer patients in China. Methods During 2018–2019, a hospital-based multicenter retrospective survey was conducted in seven provinces/municipalities across China as a part of the Cancer Screening Program of Urban China. CHE was measured according to the proportion of out-of-pocket (OOP) health payments of households on non-food expenditures. Chi-square tests and logistic regression analysis was adjusted to determine the factors that significantly influenced the likelihood of a household with lung cancer patient to incur in CHE. Results In total, 470 households with lung cancer patients were included in the analysis. Health insurance was shown to protect some households from the impact of CHE. Nonetheless, CHE incidence (78.1%) and intensity (14.02% for average distance and 22.56% for relative distance) were still relatively high among households with lung cancer patients. The incidence was lower in households covered by the Urban Employee Basic Medical Insurance (UEMBI) insurance, with higher income level and shorter disease course. Conclusion More attention is needed for CHE incidence among vulnerable populations in China. Households with lung cancer patients were shown to be more likely to develop CHE. Therefore, policy makers should focus on improving the financial protection and reducing the economic burden of this disease.

scholarly journals Health Care Expenditure Burden of Cancer Care in the United States

2019 ◽  
Vol 56 ◽  
pp. 004695801988069 ◽  
Author(s):  
Joohyun Park ◽  
Kevin A. Look
Keyword(s):  
Lung Cancer ◽  
Health Care ◽  
Cancer Patients ◽  
Cancer Care ◽  
Health Care Expenditure ◽  
Health Care Expenditures ◽  
The United States ◽  
Lung Cancer Patients ◽  
Service Type ◽  
Policies And Programs

Using nationwide data, this study estimated and compared annual health care expenditures per person between noncancer and cancer patients, and among patients with the 4 most common cancers. Two-part models were used to estimate mean expenditures for each group by source of payment and by service type. We found that cancer patients had nearly 4 times higher mean expenditures per person ($16 346) than those without cancer ($4484). These differences were larger among individuals aged 18 to 64 years than those ≥65 years. Medicare was the largest source of payment for cancer patients, especially among those ≥65 years. Among the 4 most common cancers, the most costly cancer was lung cancer. Ambulatory care visits accounted for the majority of health care expenditures for those with breast cancer, while for those with other cancers, inpatient services also contributed to a significant portion of expenditures especially among younger patients. This study demonstrates that cancer patients experience a substantially higher health care expenditure burden than noncancer patients, with lung cancer patients having the highest expenditures. Expenditure estimates varied by age group, source of payment, and service type, highlighting the need for comprehensive policies and programs to reduce the costs of cancer care.

scholarly journals Trends in Obesity and Medical Expenditure among Women with Diabetes, 2008-2016: Differences by Race/Ethnicity

2020 ◽  
Vol 30 (4) ◽  
pp. 621-628
Author(s):  
Joni S. Williams ◽  
Kaiwei Lu ◽  
Olaitan Akinboboye ◽  
Oluwatoyin Olukotun ◽  
Zhipeng Zhou ◽  
...  
Keyword(s):  
Medical Expenditure Panel Survey ◽  
Hispanic Women ◽  
Statistical Significance ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Outcome Variable ◽  
Income Insurance ◽  
Obesity Trends ◽  
Race Ethnicity ◽  
Nationally Representative

Objectives: Diabetes results in $327 billion in medical expenditures annually, while obesity, a risk factor for type 2 diabetes, leads to more than $147 billion in expendi­ture annually. The aims of this study were: 1) to evaluate racial/ethnic trends in obesity and medical expenditures; and 2) to assess incremental medical expenditures among a nationally representative sample of women with diabetes.Methods: Nine years of data (2008–2016) from the Medical Expenditure Panel Survey Full Year Consolidated File (unweighted = 11,755; weighted = 10,685,090) were used. The outcome variable was medical expenditure. The primary independent variable was race/ethnicity defined as non-Hispanic Black (NHB), Hispanic, or non-Hispanic White (NHW). Covariates included age, education, marital status, income, insurance, employment, region, comorbidity, and year. Cochran-Armitage tests determined statistical significance of trends in obesity and mean expenditure. Two-part modeling using Probit and gamma distribution was used to assess incremental medical expenditure. Data were clustered to 2008-2010, 2011-2013, 2014-2016.Results: Trends in medical expenditures dif­fered significantly between NHB and NHW women between 2008-2016 (P<.001). His­panic women paid $1,291 less compared with NHW women, after adjusting for rel­evant covariates. There were no significant differences in obesity trends from 2008- 2016 between NHB (P=.989) or Hispanic women with diabetes (P=.938) compared with NHW women with diabetes.Conclusions: These findings suggest the need to further understand the factors asso­ciated with differences in trends for medical expenditures between NHB and NHW women with diabetes and incremental med­ical expenditures in Hispanic women with diabetes compared with NHW women with diabetes.Ethn Dis. 2020;30(4);621-628; doi:10.18865/ed.30.4.621

Total cost of lung cancer care associated with broad panel versus narrow panel sequencing.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7077-7077
Author(s):  
Rogelio Alberto Brito ◽  
Bob Cullum ◽  
Kevin Hastings ◽  
Elisea Avalos-Reyes ◽  
Rebecca Karos ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Cancer Care ◽  
Lung Tumor ◽  
Progression Free Survival ◽  
Cost Of Care ◽  
Total Cost ◽  
Lung Cancer Patients ◽  
Genomic Test ◽  
Panel Sequencing

7077 Background: Many lung cancer patients are diagnosed late with advanced or metastatic disease. Targeted therapies can improve quality of life and increase the chances of progression-free survival versus conventional treatments. An understanding that there may be more than one driver mutation associated with a specific lung tumor is crucial for the timing and delivery of the most effective line of therapy. Broad panel sequencing (BPS) minimizes tissue use and enables personalized treatment that decreases the use of ineffective agents and unwarranted side effects, in addition to opening pathways to early clinical trials. However, many payors do not reimburse for BPS. The objective of this study was to determine if BPS leads to lower total cost of care versus narrow panel sequencing (NPS). Methods: We identified new lung cancer patients who completed BPS (Current Procedural Terminology (CPT) code 81455, 51+ genomic test) or NPS (CPT code 81445, 5-50 genomic test) using medical claims from January 1, 2018, to March 31, 2019. We defined total cost of care as allowed costs paid for medical and pharmacy claims across a six-month time period from the first gene sequencing panel. We also compared the allowed costs of BPS and NPS. A Student’s t-test was used to compare differences and results are presented as mean +/- standard deviation. Results: From January 2018 to March 2019, we identified 45 patients who underwent BPS sequencing and 399 patients who underwent NPS. The average BPS cost was $1,977 +/- $2,713 versus the average NPS lab cost $719 +/- $1,087, p < 0.0001. The average 6-month per member per month (PMPM) total cost was $11,535 +/- $9,168 among those who underwent BPS compared to $20,039 +/-19,642 in those who underwent NPS. This difference of $8,504 was statistically significant, p = 0.0022. Conclusions: BPS has been shown to optimize treatments in patients with lung cancer. These initial results of claims suggest that while lung cancer patients undergoing BPS have higher total sequencing costs than those undergoing NPS, BPS significantly reduces overall total cost of lung cancer care. Identifying the broader genomic landscape of a patient’s tumor earlier will empower oncology providers and lung cancer patients with information to make timely, precise treatment decisions that are ultimately more cost effective.

A comparison of two models of multidisciplinary lung cancer care within a community-based healthcare system.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 36-36
Author(s):  
Meghan Meadows ◽  
Meredith Ray ◽  
Matthew Smeltzer ◽  
Nicholas Faris ◽  
Carrie Fehnel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Care ◽  
Cox Regression ◽  
Care Delivery ◽  
Smoking Status ◽  
Multidisciplinary Care ◽  
Chi Square ◽  
Community Healthcare ◽  
Lung Cancer Patients ◽  
Chi Square Test

36 Background: The Multidisciplinary Thoracic Oncology Conference (MTOC) model is easier to implement than the Multidisciplinary Clinic (MDC) model, but does not directly involve patients in decision-making. We compared the processes and outcomes of lung cancer care between patients discussed in a weekly MTOC versus those seen in a MDC. Methods: Prospective observational study of thoroughness of staging, stage confirmation (defined as biopsy of the stage-defining lesion), National Comprehensive Cancer Network guideline-concordant treatment, overall (OS) and event-free (EFS) survival of lung cancer patients in a community healthcare system’s MDC and MTOC from 2014-2019. We used the chi-square test and multivariable logistic regression to evaluate guideline-concordant treatment and stage confirmation; Kaplan-Meier curves and multivariable Cox regression were used to evaluate OS and EFS. We adjusted models for age, sex, race, insurance, smoking status, and histology. Results: 614 patients received care in MDC; 571 in MTOC. MDC patients were older (median age: 69 vs. 67); less likely to be active smokers (44% vs. 47%; p=0.03); more likely to have bimodal (98% v 95%, p=0.02) and trimodal staging (60% v 46%, p<0.0001). The stage-confirmation rate (OR: 1.55; 95% CI: 1.22-1.96) and mediastinal stage confirmation rate (OR: 1.55; 95% CI: 1.23-1.95) were both significantly higher in MDC, even after adjustment (aOR: 1.60; 95% CI: 1.25-2.03); (aOR: 1.58, 95% CI: 1.25-2.00). A higher proportion of patients received guideline-concordant treatment in MDC than in MTOC (82% vs. 73%; OR: 1.63; 95% CI: 1.21-2.20) even after adjustment (aOR: 1.64; 95% CI: 1.20-2.24). However, MTOC patients had significantly better OS (p=0.03) and EFS (p=0.001) than MDC patients and a lower hazard of death (HR: 0.81; 95% CI: 0.67-0.98), even after adjusting for confounding variables (aHR: 0.79 95%CI: 0.66-0.95). Conclusions: Although the processes of lung cancer care delivery were better in MDC than in MTOC, survival was better in MTOC. Patient selection may have played a role in these survival differences. The MTOC model, as implemented, seems competitive with the MDC model and is worthy of further exploration as a more feasible model of multidisciplinary care. [Table: see text]

scholarly journals Trends in Medical Care Expenditures of US Adults with Arthritis and Other Rheumatic Conditions 1997 to 2005

2009 ◽  
Vol 36 (11) ◽  
pp. 2531-2538 ◽  
Author(s):  
MIRIAM G. CISTERNAS ◽  
LOUISE B. MURPHY ◽  
EDWARD H. YELIN ◽  
AIMEE J. FOREMAN ◽  
DAVID J. PASTA ◽  
...  
Keyword(s):  
Medical Expenditure Panel Survey ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Population Increase ◽  
Comorbid Condition ◽  
The Us ◽  
Rheumatic Conditions ◽  
Nationally Representative ◽  
Relative Decline ◽  
Comorbidity Status

Objective.To examine trends in annual medical expenditures from 1997 to 2005 among adults with arthritis and other rheumatic conditions (denoted Arthritis group).Methods.We analyzed annual medical expenditures (2005 US dollars) among adults with Arthritis using the Medical Expenditure Panel Survey (MEPS), a nationally representative survey of the US civilian, noninstitutionalized population. Expenditures were stratified by Arthritis and comorbidity status.Results.The Arthritis population increased by 22% (36.8 to 44.9 million) during this period, attributable entirely to the subpopulation with at least one comorbid condition (31.8 to 40.3 million). The overall, inflation-adjusted annual mean medical expenditures for adults with Arthritis increased from $6,848 in 1997 to $7,854 in 2005. In 1997, inpatient care was the most expensive component of overall expenditures (mean $2,702), but beginning in 2001, mean inpatient and ambulatory expenditures were almost identical. Mean prescription expenditures increased nearly every year, almost doubling from $970 in 1997 to $1,811 in 2005. Aggregate total expenditures for the Arthritis population increased markedly during this period, from $252.0 to $353.0 billion (+40%). Most of this increase was attributable to the population increase in the Arthritis and comorbid condition subgroup.Conclusion.Mean annual ambulatory and prescription expenditures for adults with Arthritis increased far above the rate of medical inflation, offsetting a relative decline in inpatient expenditures. Increases in overall mean and aggregate total expenditures are attributable to the increasing number of adults with Arthritis and at least one comorbid chronic condition. Projected increases in this population suggest that these expenditures will continue to rise.

Abstract C47: Hispanic/Latino lung cancer patients overcoming barriers for accessing cancer care: A qualitative study

2014 ◽  
Author(s):  
William Alago ◽  
Elyse Shuk ◽  
Ana-Motta Moss ◽  
George Brandon ◽  
Abraham Aragones ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Qualitative Study ◽  
Cancer Patients ◽  
Cancer Care ◽  
Lung Cancer Patients
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