To address the knowledge gap regarding medical care costs for advanced cancer patients, we compared costs for recurrent versus de novo stage breast, colorectal, and lung cancer patients.
Data Sources/Study Setting
Virtual Data Warehouse () information from three Kaiser Permanente regions: Colorado, Northwest, and Washington.
We identified patients aged ≥21 with de novo or recurrent breast ( = 352; = 765), colorectal ( = 1,072; = 542), and lung ( = 4,041; = 340) cancers diagnosed 2000–2012. We estimated average total monthly and annual costs in the 12 months preceding, month of, and 12 months following the index de novo/recurrence date, stratified by age at diagnosis (<65, ≥65). Generalized linear repeated‐measures models controlled for demographics and comorbidity.
In the pre‐index period, monthly costs were higher for recurrent than for de novo breast (<65: +$2,431; ≥65: +$1,360), colorectal (<65: +$3,219; ≥65: +$2,247), and lung cancer (<65: +$3,086; ≥65: +$2,260) patients. Conversely, during the index and post‐index periods, costs were higher for de novo patients. Average total annual pre‐index costs were five‐ to ninefold higher for recurrent versus de novo patients <65.
Cost differences by type of advanced cancer and by age suggest heterogeneous patterns of care that merit further investigation.
