The economic burden of supportive care of cancer patients

Goals of work: Economic and regulatory healthcare policy is limited by the lack of population-based information on the cost of supportive care of cancer patients. The goal of this study was to estimate these costs and to explore the impact of these costs on policy decisions. Patients and methods: We identified estimates of the cost of outpatient and inpatient supportive care from published reports in the literature. The range of these costs (from lowest to highest) is described for each supportive care condition. These estimates were supplemented by computing the cost of all hospitalizations for these conditions in Texas between June 2000 and December 2001. Medicare payments were used to estimate average reimbursement. Costs (not charges) were standardized to 2002 US dollars using the consumer price index for medical care and Medicare's cost-to-charge ratio for Texas. Main results: Inpatient care for most conditions exceeded $7000 per episode. Our population-based estimates of the cost of care were similar to literature-based estimates, except in the case where conditions could be managed in the outpatient setting. Average Medicare payments were often far lower than the estimated cost of care. For example, the estimated cost of hospitalization for management of diarrhea was $6616 while the average Medicare payment was only $2809. Conclusions: Many supportive care interventions are quite expensive. In an environment focused on cost containment, a risk-based approach to expensive supportive care treatments is essential. Further study of the cost effectiveness of supportive care management strategies is indicated.