A 5% annual rise in the costs of initial and final-stage care for patients would increase the total costs of cancer care in the US to $207 billion by 2020, representing a rise of 66% from 2010’s level of $124.57 billion, says new research.
Just a 2% annual rise in these costs would push the bill up 39% to $173 billion by 2020, adds the study, which was published on-line in The Journal of the National Cancer Institute last week.
And, based purely on the projected aging and growth of the US population, the costs of cancer care would increase from $124.7 billion for 13.8 million cancer survivors in 2010 to just under $158 billion for 18.1 million survivors in 2020, a rise of 27% over the decade, say the researchers, Dr Angela Mariotto and colleagues from the National Cancer Institute (NCI).
While current estimates of the costs of cancer care in the US are based on data from 2003 and earlier, patterns of incidence, survival and practice have been changing for the majority of cancers, they note. Moreover, with changes in risk factor prevalence and stage at diagnosis plus the development of new diagnostic tools and treatments, the incidence of cancer has generally declined and survival improved, but care has become more expensive, they add.
“Costs of care for cancer patients who die of their disease follows a ‘U-shaped’ curve, with the highest costs in the initial phase following diagnosis and the phase before death, and the lowest costs in the period in-between, the continuing phase,” they write.
Although the cost of cancer care per person varies tremendously by cancer site, the overall US burden is driven by prevalence, says the study. For example, the cost per person of female breast cancer care in each phase is among the lowest, but the total cost of breast cancer in 2020 is projected to be the highest ($20.5 billion) because of the large number of women living with breast cancer in each phase of care. The highest increases in costs for cancer care between 2010 and 2020 are projected for female breast cancer (32%) and prostate cancer (42%) patients in the continuing phase, representing a higher proportion of long-term survivors.
The incidence of most types of cancer is decreasing, but the absolute number of individuals diagnosed with the disease will continue to rise because of population changes, say the authors. It is likely that new tools for diagnosis, treatment and follow-up of cancer patients will be developed and will be more expensive and that, with expected growth in use of targeted chemotherapies, increases in the cost of a course of treatment are expected to escalate more rapidly. However, trends in costs associated with the use of targeted chemotherapies might be mitigated somewhat through the use of genomic-based prognostic markers, they add.
The authors conclude that while expanding costs of cancer care due to increases in an aging population are inevitable, the costs of new treatments and diagnostic technologies could potentially be managed to ensure access to quality care for all patients. The findings of their study “have implications for policy makers in planning and allocation of resources,” they add.