Cost drivers of locally advanced rectal cancer treatment-An analysis of a leading healthcare insurer.

Details

Serval ID
serval:BIB_B5ED895D7FCA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cost drivers of locally advanced rectal cancer treatment-An analysis of a leading healthcare insurer.
Journal
Journal of surgical oncology
Author(s)
Grass F., Merchea A., Mathis K.L., Mishra N., Heien H., Sangaralingham L.R., Larson D.W.
ISSN
1096-9098 (Electronic)
ISSN-L
0022-4790
Publication state
Published
Issued date
03/2021
Peer-reviewed
Oui
Volume
123
Number
4
Pages
1023-1029
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To evaluate the economic burden of locally advanced rectal cancer (LARC) treatment from a society perspective through analysis of health insurance-derived data of commercially insured and Medicare Advantage (MA) patients.
Retrospective cost analysis of patients undergoing rectal resection within a multimodal (neoadjuvant chemoradiation + adjuvant chemotherapy) treatment strategy between January 1, 2010 and October 31, 2018, using the claims OptumLabs Data Warehouse database.
In total, 1738 (935 commercial and 803 MA) patients were included. Overall treatment costs totaled $230,881,746 (on average $183 653 ± 82 384 per commercially insured and $73 681 ± 32 917 per MA patient). Cost distribution according to category (commercially insured patients) was: 29.92% related to outpatient care (follow-up visits/diagnostics), radiotherapy: 21.83%, index resection: 20.62%, chemotherapy: 17.44%, surgical inpatient: 6.32%, medical inpatient: 3.28%, emergency room: 0.58%. Relative cost distribution of the index resection itself differed marginally between the three approaches and was 21.49% for open, 19.30% for laparoscopic, and 20.93% for robotic surgery. Relative cost distributions of neoadjuvant, adjuvant, and outpatient treatments remained unchanged, independently of the surgical approach. This representation was similar in MA patients.
Index-surgery related costs were outweighed by costs related to oncological and outpatient workup/follow-up treatments independently of both surgical approach and insurance type.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Combined Modality Therapy, Cost of Illness, Female, Follow-Up Studies, Health Care Costs/statistics & numerical data, Humans, Insurance Carriers/statistics & numerical data, Insurance, Health, Male, Medicare/statistics & numerical data, Middle Aged, Neoadjuvant Therapy/economics, Proctectomy/economics, Prognosis, Rectal Neoplasms/economics, Rectal Neoplasms/epidemiology, Rectal Neoplasms/therapy, Retrospective Studies, Survival Rate, United States/epidemiology, Young Adult, cost, multidisciplinary, rectal cancer treatment
Pubmed
Web of science
Open Access
Yes
Create date
10/02/2021 9:05
Last modification date
28/10/2021 5:45
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