Health Care Costs Increase With Metastatic Cancer Progression

Progression of metastatic breast cancer, metastatic colorectal cancer, and metastatic lung cancer is associated with higher 12-month health care costs, according to a study that looked at real-world incremental costs of disease progression recently published in The Oncologist. 

“To reduce health care costs and improve care, payers and physician groups are piloting value-based and episodic or bundled-care payment models in oncology,” researchers wrote. “Disease progression and associated costs may affect these models, particularly if such programs do not account for disease severity and progression risk across patient populations.” 

The retrospective study was based on US claims data for 5709 patients with metastatic breast cancer, 3707 patients with metastatic colorectal cancer, and 5201 patients with metastatic lung cancer. Over a period of 12 months, evidence of disease progression was found in 56.8% of the study population with breast cancer, 58.1% of those with colorectal cancer, and 80.3% with lung cancer. 

Over a 12-month period, health care costs were higher for patients with disease progression compared with patients without disease progression, the study found. Per-patient-per-month costs were nearly twice as high for patients with disease progression. 

Delays in disease progression, on the other hand, were associated with lower health care costs for patients with each type of cancer.

“The data obtained in our study quantify the economic value of delaying or preventing disease progression and may inform payers and physician groups about value-based payment programs,” researchers wrote. —Jolynn Tumolo