Dr Debra Patt Breaks Down Rising Cancer Care Costs

Although cancer care costs are rising, it is proportional to the total utilization of healthcare resources and spending growth is happening more in areas that have seen innovation, explained Debra Patt, MD, MPH, MBA, director of public policy at Texas Oncology.

Transcript (slightly modified)

What are the major contributors to the high cost of cancer care?

So cancer care is expensive and as new therapies have been developed and approved it’s gotten more expensive over time. Some of those therapies contribute greatly to progression-free survival and overall survival; and so when we did the study with Milliman, looking at total cost of care through the Truven MarketScan Database, which is a commercial database and the Medicare 5% population, we looked over an 11-year period and we saw that during that time total costs of cancer care did rise, but at a rate that was proportional to total healthcare resource utilization. So for actively-treated cancer patients, for patients with a history of cancer, and for the total population, there was proportional growth. So it wasn’t disproportionate.

Then we looked at the second part, which was to look at categorical healthcare resource utilizations—so for actively-treated cancer patients, the per-patient per-year costs—to look at percentage spends in different categories, things like surgeries, and hospitalizations, and chemotherapy, and biologics. What we did see is there has been growth in chemotherapy and biologic therapy over that 11-year period in both the Medicare database and in the commercial population. I think this is representative of what we see today, but I would say that growth proportionally was a small percentage of change, and there were other decreases in percentage spending and hospitalizations.

When we looked by disease type to understand why this categorical change is occurring, we could see that there were certain diseases where healthcare resource utilization had increased more. So for example, blood disorders, breast in the commercial population, prostate in the commercial population. Those were diseases that had grown more than average spending. And if we look historically to why that might happen, we know that there are innovations in those specific disease states that have occurred over the last 11 years.

So for example, in myeloma I know that in 2006, when I graduated fellowship, we would tell people with a new diagnosis of multiple myeloma that they had an average survival of about 3 years. Today I don’t say that. Because today I know that, on average, their survival is certainly over 6 years, and it continues to improve as a response to that innovation.