Comparing Childhood Cancer Care Costs in Two Canadian Provinces

Abstract

Background: Cancer in children presents unique issues for diagnosis, treatment and survivorship care. Phase-specific comparative cost estimates are important for informing healthcare planning. Objectives: The aim of this paper is to compare direct medical costs of childhood cancer by phase of care in British Columbia (BC) and Ontario (ON). Methods: For cancer patients diagnosed at <15 years of age and propensity-score-matched non-cancer controls, we applied standard costing methodology using population-based healthcare administrative data to estimate and compare phase-based costs by province. Results: Phase-specific cancer-attributable costs were 2%–39% higher for ON than for BC. Leukemia pre-diagnosis costs and annual lymphoma continuing care costs were >50% higher in ON. Phase-specific in-patient hospital costs (the major cost category) represented 63%–82% of ON costs, versus 43%–73% of BC costs. Phase-specific diagnostic tests and procedures accounted for 1.0%–3.4% of ON costs and 2.8%–13.0% of BC costs. Conclusions: There are substantial cost differences between these two Canadian provinces, BC and ON, possibly identifying opportunities for healthcare planning improvement.

Healthcare costs of cancer among children, adolescents, and young adults: A scoping review

“…The selected studies were conducted across 13 countries, predominantly in the United States ( n = 12, 40%) 25–36 and Canada ( n = 5, 17%) 37–41 . Australia 42,43 and the Netherlands 44,45 reported two studies each while nine other countries including France, Chile, Korea, India, Mexico, Spain, Egypt, Thailand, and China had one study (Table 1, Table S2).…”

“…More than half of the studies (n = 16, 53%) reported costs for both children and adolescents 0-19 years. Other studies were exclusive to children 0 to 14 years (n = 4, 13%), 39,[47][48][49] AYA aged 15 to 39 years (n = 5, 17%), 25,26,30,33,36 or adolescents 15 to 19 years (n = 1, 3%). 40 Four studies (n = 4, 13%) covered the whole spectrum of children and AYA aged 0-39 years 27,28,31,46 (Table 1, Table S1).…”

“…There was a wide mix of cost components mostly comprising hospital use or inpatient care (n = 21, 70%) as shown in Figure 2 and Table S5. 27,29,[32][33][34]43,48 The largest contributor to healthcare costs, according to nine studies, 33,35,[37][38][39]41,50,51,54 was hospitalizations, accounting for 45% to 93% of total costs (Table S4).…”

“…54 3.12 | Costs related to end-of-life care and palliative care Compared to other phases of care, costs were generally higher during the end-of-life care phase, commonly referred to as the last 12 months of life. The cost of endof-life care is higher for children than for adolescents in Canada, at over US$300,000 39,41 and US$235,265, 41 respectively. In a US study of children with cancer and a high in hospital mortality, those receiving palliative care had lower hospital costs compared to those not receiving palliative care estimated at US$83,403 and S$152,179, respectively 29 (Table 2).…”

Kicking off the 2020s with Healthcare Policy

“…This issue also features an interprovincial comparison of childhood cancer costs by McBride and colleagues (2020) , which provides valuable insights into variations in care delivery. Zoratti and colleagues (2020) report on a three-province comparison of drug reimbursement recommendations, whereas Bell and colleagues (2020) explore equity in accessing allogeneic stem cell transplant and Antonipillai and colleagues (2020) explore Canadian refugee health policy.…”