Costs of treatment for elderly women with advanced ovarian cancer in a Medicare population

Forde, Gareth K.; Chang, Jenny; Ziogas, Argyrios; Tewari, K.; Bristow, Robert E.

doi:10.1016/j.ygyno.2015.03.050

Cited by 13 publications

(9 citation statements)

References 16 publications

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“…For example, costs were $13,369 and $25,739 higher among cancer survivors of all sites in Medicaid in Georgia, Maine, or Illinois with 2 comorbidities and ≥3 comorbidities, respectively, compared to cancer survivors with no additional comorbidities (US$ 2003) [21]. Similar trends were found across several studies for thyroid, oral cavity, pharyngeal, colon, and ovarian cancer survivors [25,28,30,31,33]. …”

Section: Resultsmentioning

confidence: 59%

“…Having one additional comorbidity compared to none was associated with increased annual costs of $2762 among colon cancer survivors with Medicare/Medicaid in Michigan (US$ 2001) [33], and increased 6-month costs of $4584 among cancer survivors of all sites in Medicaid patients in Georgia, Maine, or Illinois (US$ 2003) [21]. For ovarian cancer patients, the 7-month cost of care (US$ 2010 dollars) for having one comorbidity (compared to none) was $1793 for stage IIIC patients and $5625 for stage IV patients [28]. As the number of comorbidities increased, the cost attributed to comorbidities increased substantially.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The impact of chronic conditions on the economic burden of cancer survivorship: a systematic review

Rim

Guy

Yabroff

et al. 2016

Expert Review of Pharmacoeconomics & Outcomes Research

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Introduction This systematic review examines the excess cost of chronic conditions on the economic burden of cancer survivorship among adults in the US. Areas covered Twelve published studies were identified. Although studies varied substantially in populations, comorbidities examined, methods, and types of cost reported, costs for cancer survivors with comorbidities generally increased with greater numbers of comorbidities or an increase in comorbidity index score. Survivors with comorbidities incurred significantly more in total medical costs, out-of-pocket costs, and costs by service type compared to cancer survivors without additional comorbidities. Expert commentary Cancer survivors with comorbidities bear significant excess out-of-pocket costs and their care is also more expensive to the healthcare system. On-going evaluation of different payment models, care coordination, and disease management programs for cancer survivors with comorbidities will be important in monitoring impact on healthcare costs.

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Section: Resultsmentioning

confidence: 59%

Section: Resultsmentioning

confidence: 99%

The impact of chronic conditions on the economic burden of cancer survivorship: a systematic review

Rim

Guy

Yabroff

et al. 2016

Expert Review of Pharmacoeconomics & Outcomes Research

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“…Among 4,506 older women with advanced ovarian cancer, the costs associated with PCS and NACT were similar for women with stage IIIC disease, but PCS was associated with higher costs in women with stage IV disease. 53 The cost of care among older women (age ≥ 65 years) with advanced ovarian cancer has also been evaluated using a 5-year Markov model, which assumed similar overall survival with PCS and NACT based upon the results of EORTC 55971. 54 In this study, NACT was associated with a cost savings of $5,616 compared with PCS, when costs included surgery, chemotherapy, and hospital stays.…”

Section: Cost Implicationsmentioning

confidence: 99%

Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: Society of Gynecologic Oncology and American Society of Clinical Oncology Clinical Practice Guideline

Wright

Bohlke

Armstrong

et al. 2016

JCO

366

283

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Purpose To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer. Methods The Society of Gynecologic Oncology and the American Society of Clinical Oncology convened an Expert Panel and conducted a systematic review of the literature. Results Four phase III clinical trials form the primary evidence base for the recommendations. The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer, neoadjuvant chemotherapy and interval cytoreduction are noninferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality. Recommendations All women with suspected stage IIIC or IV invasive epithelial ovarian cancer should be evaluated by a gynecologic oncologist prior to initiation of therapy. The primary clinical evaluation should include a CT of the abdomen and pelvis, and chest imaging (CT preferred). Women with a high perioperative risk profile or a low likelihood of achieving cytoreduction to <1 cm of residual disease (ideally to no visible disease) should receive neoadjuvant chemotherapy. Women who are fit for primary cytoreductive surgery, and with potentially resectable disease, may receive either neoadjuvant chemotherapy or primary cytoreductive surgery. However, primary cytoreductive surgery is preferred if there is a high likelihood of achieving cytoreduction to < 1 cm (ideally to no visible disease) with acceptable morbidity. Before neoadjuvant chemotherapy is delivered, all patients should have confirmation of an invasive ovarian, fallopian tube, or peritoneal cancer. Additional information is available at www.asco.org/NACT-ovarian-guideline and www.asco.org/guidelineswiki.

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“…6–9 A recent study of Medicare beneficiaries estimated that the mean cost of care during the first year after diagnosis was approximately $66,000. 8 Estimates of how these costs are shared by patients are limited.…”

Section: Introductionmentioning

confidence: 99%

Cost of Care for the Initial Management of Ovarian Cancer

Bercow

Chen

Chatterjee

et al. 2017

Obstetrics &Amp; Gynecology

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Objective To examine the cost of care during the first year after a diagnosis of ovarian cancer, estimate the sources of cost, and explore the out-of-pocket costs. Methods We performed a retrospective, cohort study of women with ovarian cancer diagnosed from 2009–2012 who underwent both surgery using the Truven Health MarketScan database. This database is comprised of patients covered by commercial insurance sponsored by over 100 employers in the United States. Medical expenditures, including physician reimbursement, for a 12-month period beginning on the date of surgery were estimated. All payments were examined, including out-of-pocket costs for patients. Payments were divided into expenditures for inpatient care, outpatient care (including chemotherapy), and outpatient drug costs. The 12-month treatment period was divided into 3 phases: surgery-30 days (operative period), 1–6 months (adjuvant therapy), and 6–12 months after surgery. The primary outcome was the overall cost of care within the first year of diagnosis of ovarian cancer, while secondary outcomes included assessment of factors associated with cost. Results A total of 26,548 women with ovarian cancer who underwent surgery were identified. After exclusion of patients with incomplete insurance enrollment/coverage, those who did not undergo chemotherapy, and those with capitated plans, our cohort consisted of 5,031 women. The median total medical expenditures per patient during the first year after the index procedure was $93,632 (interquartile range [IQR] $62,319–140,140). Inpatient services accounted for $30,708 (IQR, $20,102–51,107; 37.8%) in expenditures, outpatient services $52,700 (IQR, $31,210–83,206; 58.3%) and outpatient drug costs $1,814 (IQR, $603–4,402; 3.8%). The median out-of-pocket expense was $2988 (IQR, $1649–5088). This included $1509 (IQR, $705–2878) for outpatient services, $589 (IQR, $3–1715) for inpatient services, and $351 (IQR, $149–656) for outpatient drug costs. Conclusion The average cost of care for women with ovarian cancer in the first year after surgery is approximately $100,000. Patients bear approximately 3% of these costs in the form of out-of-pocket expenses.

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Costs of treatment for elderly women with advanced ovarian cancer in a Medicare population

Cited by 13 publications

References 16 publications

The impact of chronic conditions on the economic burden of cancer survivorship: a systematic review

The impact of chronic conditions on the economic burden of cancer survivorship: a systematic review

Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: Society of Gynecologic Oncology and American Society of Clinical Oncology Clinical Practice Guideline

Cost of Care for the Initial Management of Ovarian Cancer

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