Lifetime Costs of Surviving Cancer—A Queensland Study (COS-Q): Protocol of a Large Healthcare Data Linkage Study

Abstract

Australia-wide, there are currently more than one million cancer survivors. There are over 32 million world-wide. A trend of increasing cancer incidence, medical innovations and extended survival places growing pressure on healthcare systems to manage the ongoing and late effects of cancer treatment. There are no published studies of the long-term health service use and cost of cancer survivorship on a population basis in Australia. All residents of the state of Queensland, Australia, diagnosed with a first primary malignancy from 1997–2015 formed the cohort of interest. State and national healthcare databases are linked with cancer registry records to capture all health service utilization and healthcare costs for 20 years (or death, if this occurs first), starting from the date of cancer diagnosis, including hospital admissions, emergency presentations, healthcare costing data, Medicare services and pharmaceuticals. Data analyses include regression and economic modeling. We capture the whole journey of health service contact and estimate long-term costs of all cancer patients diagnosed and treated in Queensland by linking routinely collected state and national healthcare data. Our results may improve the understanding of lifetime health effects faced by cancer survivors and estimate related healthcare costs. Research outcomes may inform policy and facilitate future planning for the allocation of healthcare resources according to the burden of disease.

Cancer Survivors’ Long-Term Health Service Costs in Queensland, Australia: Results of a Population-Level Data Linkage Study (Cos-Q)

“…A detailed description of data collection, data linkage, variables extracted (linkage variables/research variables) and data storage was provided in our Study Protocol manuscript [ 33 ] and is summarized below.…”

“…We investigated long-term health service use (i.e., up to 19 years after diagnosis) and associated costs for cancer survivors on a population level [ 33 ] from an Australian health service perspective. The aim of this study was to quantify long-term health service costs of cancer survivorship on a population level in Queensland, Australia.…”

Australian Experiences of Out-of-Pocket Costs and Financial Burden Following a Cancer Diagnosis: A Systematic Review

“…The individual clinical and personal circumstances which influence out-of-pocket costs make it difficult to provide a true average out-of-pocket cost or to compare costs meaningfully. Research suggests that the ongoing costs to the patient of managing side effects of cancer treatment and the illness itself are also significant, having a long-term impact on patients’ quality of life and financial situation [ 31 ]. The presence and severity of co-morbidities, such as multiple skin cancers or secondary lymphoedema, can increase out-of-pocket costs and extend the period during which out-of-pocket costs are paid well beyond cancer treatment.…”

Estimated Healthcare Costs of Melanoma and Keratinocyte Skin Cancers in Australia and Aotearoa New Zealand in 2021

“…We extracted the unit costs of SLNB, complete lymph node dissection, radiotherapy, and palliative care from national cost reports [ 27 ]. Hospitalisation costs for KCs and melanoma were extracted from two hospital costing datasets that included episode costs for ICD C43-44 [ 28 , 29 ]. We derived the costs of pharmacotherapy by analysing the treatment courses and duration for 109 QSkin participants treated with ipilimumab, nivolumab, pembrolizumab, and dabrafenib/trametinib.…”

“…The following supporting information can be downloaded at: https:// www.mdpi.com/article/10.3390/ijerph19063178/s1, Table S1:Model inputs for melanoma diagnosis and treatment pathways; Table S2: Model inputs for KC diagnosis and treatment pathways; Table S3: Medicare MBS and PBS codes included in the skin cancer cost calculations; Table S4: PBS codes for melanoma pharmacotherapies; Table S5: Distribution types and parameters used in the model; Explanatory notes on analysis of QSKIN data and other published data sources; Figure S1: Results of 1-way sensitivity analysis (Australia); Figure S2: Results of 1-way sensitivity analysis (NZ). References [19,[26][27][28][29]32,[46][47][48][49][50][51] are cited in the supplementary materials.…”