Blog | Thursday, January 13, 2011

QD: News Every Day--Cancer treatments projected to cost at least $158 billion by 2020

Medical expenditures for cancer are projected to reach at least $158 billion in today's dollars by 2020. That's a 27% increase, assuming that incidence and treatment costs remain at 2010 levels, according to a National Institutes of Health analysis of growth and aging of the U.S. population.

But new diagnostic tools and treatments could raise medical expenditures as high as $207 billion, assuming that the costs of new treatments increases 5%, said the researchers from the National Cancer Institute (NCI), part of the NIH. The analysis appears in the Journal of the National Cancer Institute. Recent trends reflect a 2% annual increase in medical costs in the initial and final phases of care, which would boost projected 2020 costs to $173 billion.

Chart generated at of expenses, assuming steady incidence and survival rates and no increase in treatment costs.

Projections were based on the most recent data available on cancer incidence, survival and costs of care. In 2010, medical costs associated with cancer were projected to reach $127.6 billion, with the highest costs associated with breast cancer ($16.5 billion), followed by colorectal cancer ($14 billion), lymphoma ($12 billion), lung cancer ($12 billion) and prostate cancer ($12 billion).

For those who like to play around with numbers, an interactive feature lets users chart specific cancer types, population demographics, and assumptions about incidence, survival and costs.

To project national cancer expenditures, the researchers combined cancer prevalence with average annual costs of care by age (less than 65 or 65 and older). There were 13.8 million cancer survivors alive in 2010, 58% of whom were age 65 or older. If cancer incidence and survival rates remain stable, the number of cancer survivors in 2020 will increase by 31%, to about 18.1 million. Because of the aging of the U.S. population, the researchers expect the largest increase in cancer survivors over the next 10 years to be among Americans age 65 and older.

To develop their cost projections, the authors used average medical costs for the different phases of cancer care: the first year after diagnosis, the last year of life, and the time in between. For all types of cancer, per-person costs of care were highest in the final year of life. Per-person costs associated with the first year after a cancer diagnosis were more varied, with cancers of the brain, pancreas, ovaries, esophagus and stomach having the highest initial costs and melanoma, prostate and breast cancers having the lowest initial-year costs.

These new projections are higher than previously published estimates of direct cancer expenditures, largely because the researchers used the most recent data available, including Medicare claims data through 2006, which include payments for newer, more expensive, targeted therapies that attack specific cancer cells and often have fewer side effects. In addition, by analyzing costs according to phase of care, which revealed the higher costs of care associated with the first year of treatment and last year of life (for those who die from their disease), the researchers were able to generate more precise estimates of the cost of care.

The researchers used 2005 incidence and mortality data from NCI's Surveillance, Epidemiology and End Results (SEER) program to estimate cancer prevalence for 2010 and 2020. Population estimates for the United States was obtained from the U.S. Census Bureau's National Interim Projections for 2006 to 2020. Medical cost estimates were obtained using the SEER-Medicare database which links SEER data to Medicare claims data from the Center for Medicare and Medicaid Services.

More information about these cost projections is available online.