TY - JOUR
T1 - Total and out-of-pocket costs of different primary management strategies in ovarian cancer
AU - Suidan, Rudy S.
AU - He, Weiguo
AU - Sun, Charlotte C.
AU - Zhao, Hui
AU - Rauh-Hain, Jose Alejandro
AU - Fleming, Nicole D.
AU - Lu, Karen H.
AU - Giordano, Sharon H.
AU - Meyer, Larissa A.
N1 - Publisher Copyright:
© 2019
PY - 2019/8
Y1 - 2019/8
N2 - 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.
AB - 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.
KW - bevacizumab
KW - chemotherapy
KW - cost
KW - high-deductible health plan
KW - out-of-pocket cost
KW - ovarian cancer
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U2 - 10.1016/j.ajog.2019.04.005
DO - 10.1016/j.ajog.2019.04.005
M3 - Article
C2 - 30965052
AN - SCOPUS:85065210854
SN - 0002-9378
VL - 221
SP - 136.e1-136.e9
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 2
ER -