Total and out-of-pocket costs of different primary management strategies in ovarian cancer

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21 Scopus citations

Abstract

Background: Communicating healthcare costs to patients is an important component of delivering high-quality value-based care, yet cost data are lacking. This is especially relevant for ovarian cancer, where no clinical consensus on optimal first-line treatment exists. Objective: The objective of this study was to generate cost estimates of different primary management strategies in ovarian cancer. Study Design: All women who underwent treatment for ovarian cancer from 2006–2015 were identified from the MarketScan database (n=12,761) in this observational cohort study. Total and out-of-pocket costs were calculated with the use of all claims within 8 months from initial treatment and normalized to 2017 US dollars. The generalized linear model method was used to assess cost by strategy. Results: Among patients who underwent neoadjuvant chemotherapy and those who underwent primary debulking, mean adjusted total costs were $113,660 and $107,153 (P<.001) and mean out-of-pocket costs were $2519 and $2977 (P<.001), respectively. Total costs for patients who had intravenous standard, intravenous dose-dense, and intraperitoneal/intravenous chemotherapy were $105,047, $115,099, and $121,761 (P<.001); and out-of-pocket costs were $2838, $3405, and $2888 (P<.001), respectively. Total costs for regimens that included bevacizumab were higher than those without it ($171,468 vs $104,482; P<.001); out-of-pocket costs were $3127 vs $2898 (P<.001). Among patients who did not receive bevacizumab, 25% paid ≥$3875, and 10% paid ≥$6265. For patients who received bevacizumab, 25% paid ≥$4480, and 10% paid ≥$6635. Among patients enrolled in high-deductible health plans, median out-of-pocket costs were $4196, with 25% paying ≥$6680 and 10% paying ≥$9751. Conclusion: Costs vary across different treatment strategies, and patients bear a significant out-of-pocket burden, especially those enrolled in high-deductible health plans.

Original languageEnglish (US)
Pages (from-to)136.e1-136.e9
JournalAmerican journal of obstetrics and gynecology
Volume221
Issue number2
DOIs
StatePublished - Aug 2019

Keywords

  • bevacizumab
  • chemotherapy
  • cost
  • high-deductible health plan
  • out-of-pocket cost
  • ovarian cancer

ASJC Scopus subject areas

  • Obstetrics and Gynecology

MD Anderson CCSG core facilities

  • Clinical Trials Office

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