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Medical expenditures of adult cancer survivors aged <65 years in the United States†
Article first published online: 23 DEC 2010
Copyright © 2010 American Cancer Society
Volume 117, Issue 12, pages 2791–2800, 15 June 2011
How to Cite
Short, P. F., Moran, J. R. and Punekar, R. (2011), Medical expenditures of adult cancer survivors aged <65 years in the United States. Cancer, 117: 2791–2800. doi: 10.1002/cncr.25835
The authors thank Steven B. Cohen and Thomas M. Selden in the Center for Financing, Access, and Cost Trends of the Agency for Healthcare Research and Quality for technical assistance in creating survey weights for these analyses.
- Issue published online: 7 JUN 2011
- Article first published online: 23 DEC 2010
- Manuscript Accepted: 8 NOV 2010
- Manuscript Revised: 13 OCT 2010
- Manuscript Received: 9 AUG 2010
- cancer survivor;
- health expenditures;
- personal expenditures;
- costs of cancer;
- prescription expenditures
To the authors' knowledge, this is the first study to provide national estimates of medical expenditures for all adult cancer survivors aged <65 years. Most studies of expenditures for cancer survivors in this age group have been based on the Medical Expenditure Panel Survey (MEPS) and were limited to “affected survivors.”
MEPS expenditure data for 2001 to 2007 were linked to data identifying all survivors from the National Health Interview Survey (NHIS), which is the MEPS sampling frame. The sample was comprised of adults ages 25 to 64 years. Propensity-score matching was used to estimate the effects of cancer on average total and out-of-pocket expenditures for all services and separately for prescriptions. Probit models were used to estimate effects on the probability of exceeding different expenditure thresholds.
Mean annual expenditures on all services in 2007 were $16,910 ± $3911 for survivors who were newly diagnosed with cancer, $7992 ± $972 for survivors who had been diagnosed in previous years, and $3303 ± $103 for other adults. Fifty-three percent of survivors were not identified in MEPS but only by linking to NHIS. Expenditures for all survivors averaged approximately $9300 compared with $13,600 for “affected survivors.” For previously diagnosed survivors, the increase in mean expenditures attributable to cancer was approximately $4000 to $5000 annually. On average, relatively little of the increase was paid out of pocket, but cancer nearly doubled the risk of high out-of-pocket expenditures.
Previous MEPS analyses overstated average expenditures for all survivors. Nevertheless, the current results indicated that the increase in expenditures attributable to cancer is substantial, even for longer term survivors, and that cancer increases the relative risk of high out-of-pocket expenditures. Cancer 2011;. © 2010 American Cancer Society.