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Cost of ovarian cancer by the phase of care in the United States - 01/10/24

Doi : 10.1016/j.ajog.2024.08.023 
Naomi N. Adjei, MD, MPH a, Allen M. Haas, MS b, Charlotte C. Sun, DrPH, MPH a, Hui Zhao, PhD b, Paul G. Yeh, MD, DrPH c, Sharon H. Giordano, MD, MPH b, Iakovos Toumazis, PhD b, Larissa A. Meyer, MD, MPH a,
a Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 
b Division of Cancer Prevention and Population Sciences, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX 
c Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston School of Public Health, Houston, TX 

Corresponding author: Larissa A. Meyer, MD, MPH.
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 01 October 2024

Abstract

Background

Ovarian cancer is associated with delayed diagnosis and poor survival; thus, interest is high in identifying predictive and prognostic biomarkers and novel therapeutic agents.

Although the costs of ovarian cancer care are likely to increase as newer, more effective, but more expensive treatment regimens become available, information on the current costs of care for ovarian cancer—across the care continuum from diagnosis to the end of life—are lacking.

Objective

This study aimed to estimate real-world mean and median costs of ovarian cancer care within the first 5 years after diagnosis by patients' phase of care, age, race/ethnicity, and geographic region.

Study Design

We performed a retrospective cohort study of ovarian cancer patients diagnosed between January 1, 2015 and December 31, 2020. We used claims data from Optum’s deidentified Clinformatics Data Mart database, which includes inpatient, outpatient, and prescription claims for commercial insurance and Medicare beneficiaries nationwide. Cost of ovarian cancer care were calculated for the start of care (ie, the first 6 months), continuing care (ie, period between the initial and end-of-life care), and end-of-life care (ie, the last 6 months) phases and reported in 2021 U.S. dollar amounts. Ovarian cancer care costs were stratified by age, race/ethnicity, and geographic region. Due to the skewed nature of cost data, the mean cost data were log-transformed for modeling. Ordinary least-squares regression was conducted on the log costs, adjusting for patient categorical age, race/ethnicity, and geographic region.

Results

A total of 7913 patients were included in the analysis. The mean cost per year for ovarian cancer care was >$200,000 during the start of care, between $26,000 and $88,000 during the continuing care phase, and >$129,000 during the end-of-life care phase. There were statistically significant associations between age and costs during each phase of care. Compared to younger patients, older patients incurred higher costs during the continuing care phase and lower costs during the end-of-life care phase. Geographic differences in the costs of ovarian cancer care were also noted regardless of the phase of care. There were no associations between cost and race/ethnicity in our cohort.

Conclusion

Ovarian cancer care costs are substantial and vary by the phase of care, age category, and geographic region. As more effective but expensive treatment options for ovarian cancer become available with potential survival benefit, sustainable interventions to reduce the cost of care for ovarian cancer will be needed throughout the cancer care continuum.

Le texte complet de cet article est disponible en PDF.

Key words : commercial insurance, cost of care, Medicare, ovarian cancer


Plan


 The authors report no conflict of interest.
 N.N.A. reported research support from the National Institutes of Health T32 training grant (T32 CA101642). C.C.S. reported partial salary support from AstraZeneca. I.T. reported research support from the University of Texas MD Anderson Cancer Center Duncan Family Institute for Cancer Prevention and Risk Assessment. L.A.M. reported research support from AstraZeneca. S.H.G. reported funding from Komen SAC150061. Support was provided by the National Institutes of Health T32 training grant (T32 CA101642), the MD Anderson Cancer Center Support Grant from the National Cancer Institute of the National Institutes of Health (NIH/NCI P30 CA016672), the University of Texas MD Anderson Cancer Center Duncan Family Institute for Cancer Prevention and Risk Assessment, and Break Through Cancer. Editorial support was provided by Bryan Tutt, Scientific Editor, Research Medical Library at MD Anderson Cancer Center. The funding sources did not have a role in study design, data collection, data analyses, data interpretation, or writing of the manuscript.
 Cite this article as: Adjei NN, Haas AM, Sun CC, et al. Cost of ovarian cancer by the phase of care in the United States. Am J Obstet Gynecol 2024;XXX:XX–XX.


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