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

Autor: Amit Merchea, Nitin Mishra, Fabian Grass, Lindsey R. Sangaralingham, David W. Larson, Herbert C. Heien, Kellie L. Mathis
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Adult
Male
medicine.medical_specialty
Adolescent
Colorectal cancer
medicine.medical_treatment
Insurance Carriers
Medicare Advantage
Medicare
03 medical and health sciences
Young Adult
0302 clinical medicine
Ambulatory care
Cost of Illness
Health care
medicine
Humans
Robotic surgery
Aged
Retrospective Studies
Aged
80 and over
Chemotherapy
Insurance
Health
Proctectomy
business.industry
Rectal Neoplasms
General surgery
Combined Modality Therapy
Female
Follow-Up Studies
Health Care Costs/statistics & numerical data
Insurance Carriers/statistics & numerical data
Medicare/statistics & numerical data
Middle Aged
Neoadjuvant Therapy/economics
Proctectomy/economics
Prognosis
Rectal Neoplasms/economics
Rectal Neoplasms/epidemiology
Rectal Neoplasms/therapy
Survival Rate
United States/epidemiology
cost
multidisciplinary
rectal cancer treatment
General Medicine
Health Care Costs
medicine.disease
Neoadjuvant Therapy
United States
Radiation therapy
Oncology
Cost driver
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Surgery
business
Zdroj: Journal of surgical oncology, vol. 123, no. 4, pp. 1023-1029
Popis: Background 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. Methods 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. Results 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. Conclusion 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.
Databáze: OpenAIRE
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