January 12, 2011 | 7
Thanks to medical advances in recent decades, many millions more people are surviving for years beyond a cancer diagnosis. These leaps, however, have not come cheap. And with an aging population and expected rising costs in medical care, the financial burden of cancer is expected to rise precipitously in the next 10 years—despite decreasing incidence—according to a new study, published online January 12 in the Journal of the National Cancer Institute.
Based on Medicare data and other sources, the new analysis shows that in 2010, cancer care for 16 common types of cancers in U.S. women and 13 common types of cancers in U.S. men tallied up to $124.6 billion.
"Rising health-care costs represent a central challenge for both the federal government and the private sector," wrote the study authors, led by Angela Mariotto of the Surveillance Research Program at the National Cancer Institute. Overall 2009 healthcare costs in the U.S. were about $2.5 trillion, and spending is expected to increase to some $4.6 trillion by 2019.
Climbing cancer costs are likely to contribute to this growth. Even as the incidence rate of many common cancers is expected to continue to drop, with the baby boomers shifting into the over-65 category (the population segment that currently includes some 58 percent of those who have had cancer) and most survival rates continuing to increase, some 18.1 million people in the U.S. are expected to be living with cancer by 2020.
Assuming no increase in the cost of treatment, the total bill will jump about 27 percent in 10 years to $157.7 billion (in 2010 dollars). But, as the researchers noted, "it is likely that new tools for diagnosis, treatment, and follow-up of cancer patients will be developed and will be more expensive." As Mariotto and her colleagues explained in the paper, "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."
With just a modest medical cost climb of 2 percent per year in the early and final phases of treatment, the 2020 cancer care costs could reach $173 billion, representing a 39 percent increase from 2010 levels. But if costs increase 5 percent per year in these two phases, annual costs could spiral out 66 percent to $207 billion.
A 2009 commentary in the same journal pointed to the extreme example of lung cancer drug Erbitux, which cost about $80,000 for an 18-week treatment regime and boosted survival only an average of 1.2 months. Instances such as this have compelled many to encourage clinicians to have more open conversations with their patients about costs and expected benefits of different treatments.
The largest projected increases in costs are not, however for late-stage cancers, but rather for continuing care for female breast cancer (42 percent increase) and prostate cancer (42 percent increase), the authors noted. Taking these figures alone could help predict coming demand for both specialists and treatments down the road.
One way to help keep costs down, Mariotto and her colleagues suggested, is through the use of genomic testing to help clinicians figure out the most effective treatment for a particular form of cancer. This approach could eliminate trial-and-error testing of various therapies on individual patients. But biomarker tests are currently limited to just a few types of cancers.
In the meantime, the researchers concluded, the new projections should "be particularly useful for policy makers for understanding the future burden of cancer care and for prioritizing future resources on cancer research, treatment, and prevention."
Image courtesy of iStockphoto/ctpaul