State-level cancer care costs to jump as much as 115 percent by 2020, study says

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An analysis of cancer-related medical costs by state has projected that all U.S. states will see a substantial increase in the costs of care for cancer patients through 2020, according to the results of a study published in the September issue of The American Journal of Managed Care.

“Over the past 20 years, the cost of treating cancer has nearly doubled nationally,” wrote authors Justin G. Trogdon, PhD, of RTI International in Research Triangle Park, N.C., and colleagues.

“As a result of an aging population and more expensive cancer treatments, the national costs of cancer care are expected to increase significantly in the near future,” they added, noting that the rate of increase will vary by state.

Projections were based on pooled Medical Expenditure Panel Survey data for 2004 to 2008, and U.S. Census Bureau population projections that were used for estimates of the number of people treated for cancer by age group and sex. The authors explained that their base model assumed no change in cancer treatment rates and a 3.6 percent annual increase in inflation-adjusted per capita medical costs.

Using the base model, between 2010 and 2020 projected state-level cancer-related medical costs would increase between 34 percent, in the District of Columbia, and 115 percent, in Arizona. The median increase is projected at 72 percent. In 2010 dollars, this translates into increases between $347 million and $28.3 billion, with a median increase of $3.7 billion in state-level costs.

“Our projections of state-level percentage increases in the number of treated cancer cases between 2010 and 2020 varied significantly across states and closely paralleled projected increases in the number of residents 65 years or older,” wrote the authors. “States with the largest projected percentage increases in number of residents 65 years or older also had the largest projected percentage increases in cancer-related medical costs.”

Trogdon and colleagues noted that the largest projected increases in the number of people treated for cancer were found in Florida (353,000), California (351,000) and Texas (249,000). Percentage change in the number of cancer cases treated during the projected period ranged from -7 percent in the District of Columbia to 46 percent in Arizona.

In looking for the main drivers of the rising costs, the authors explained that declining trends in U.S. cancer incidence rates and improving cancer survival rates have little net effect on overall cost projections. However, costs of medical services was another story. Compared with the base model assumption of a 3.6 percent annual increase in medical costs, the authors explained that assumptions of 0 percent cost growth and 5 percent cost growth were 34 percent lower and 18 percent higher, respectively. Using the 0 percent cost-growth model is interesting, according to Trogdon and colleagues, because it better demonstrates the impact of population growth and aging, and at the same time might be more accurate since inflation-adjusted per-person cost of cancer treatment did not change much between 1987 and 2005.

“We hope that states find these projections useful as they try to make evidence-based decisions about the allocation of resources for cancer research and interventions as well as other policy decisions related to cancer prevention and treatment,” wrote the authors.