BACKGROUND: There is increasing concern regarding the financial burden of care on cancer patients and their families. Medicare beneficiaries often have extensive comorbidities and limited financial resources, and may face substantial cost sharing even with supplemental coverage. In the current study, the authors examined out-of-pocket (OOP) spending and burden relative to income for Medicare beneficiaries with cancer. METHODS: This retrospective, observational study pooled data for 1997 through 2007 from the Medicare Current Beneficiary Survey linked to Medicare claims. Medicare beneficiaries with newly diagnosed cancer were selected using claims-based diagnoses. Generalized linear models were used to estimate OOP spending. Logistic regression models identified factors associated with a high OOP burden, defined as spending > 20% of one's income during the cancer diagnosis and subsequent year. RESULTS: The cohort included 1868 beneficiaries with and 10,047 without cancer. Compared with the noncancer cohort, cancer patients were older, had more comorbidities, and were more likely to lack supplemental coverage. The mean OOP spending for cancer patients was $4727. Cancer patients faced an adjusted $976 (P < .01) incremental OOP spending. Greater than one-quarter (28%) of beneficiaries with cancer experienced a high OOP burden compared with 16% of beneficiaries without cancer (P < .001). Supplemental insurance and higher income were found to be protective against a high OOP burden, whereas assets, comorbidity, and receipt of cancer-directed radiation and antineoplastic therapy were associated with a higher OOP burden. CONCLUSIONS: Medicare beneficiaries with cancer face a higher OOP burden than their counterparts without cancer; some of the higher burden was explained by the higher comorbidity burden and lack of supplemental insurance noted among these patients. Financial pressures may discourage some elderly patients from pursuing treatment.
BACKGROUND: There is increasing concern regarding the financial burden of care on cancerpatients and their families. Medicare beneficiaries often have extensive comorbidities and limited financial resources, and may face substantial cost sharing even with supplemental coverage. In the current study, the authors examined out-of-pocket (OOP) spending and burden relative to income for Medicare beneficiaries with cancer. METHODS: This retrospective, observational study pooled data for 1997 through 2007 from the Medicare Current Beneficiary Survey linked to Medicare claims. Medicare beneficiaries with newly diagnosed cancer were selected using claims-based diagnoses. Generalized linear models were used to estimate OOP spending. Logistic regression models identified factors associated with a high OOP burden, defined as spending > 20% of one's income during the cancer diagnosis and subsequent year. RESULTS: The cohort included 1868 beneficiaries with and 10,047 without cancer. Compared with the noncancer cohort, cancerpatients were older, had more comorbidities, and were more likely to lack supplemental coverage. The mean OOP spending for cancerpatients was $4727. Cancerpatients faced an adjusted $976 (P < .01) incremental OOP spending. Greater than one-quarter (28%) of beneficiaries with cancer experienced a high OOP burden compared with 16% of beneficiaries without cancer (P < .001). Supplemental insurance and higher income were found to be protective against a high OOP burden, whereas assets, comorbidity, and receipt of cancer-directed radiation and antineoplastic therapy were associated with a higher OOP burden. CONCLUSIONS: Medicare beneficiaries with cancer face a higher OOP burden than their counterparts without cancer; some of the higher burden was explained by the higher comorbidity burden and lack of supplemental insurance noted among these patients. Financial pressures may discourage some elderly patients from pursuing treatment.
Authors: Alex Z Fu; Huei-Ting Tsai; John L Marshall; Andrew N Freedman; Arnold L Potosky Journal: J Oncol Pharm Pract Date: 2013-10-11 Impact factor: 1.809
Authors: Sun Hee Rim; Gery P Guy; K Robin Yabroff; Kathleen A McGraw; Donatus U Ekwueme Journal: Expert Rev Pharmacoecon Outcomes Res Date: 2016-10-06 Impact factor: 2.217
Authors: Nynikka R A Palmer; Ann M Geiger; Lingyi Lu; L Douglas Case; Kathryn E Weaver Journal: Cancer Epidemiol Biomarkers Prev Date: 2013-10 Impact factor: 4.254
Authors: Matthew P Banegas; John F Dickerson; Erin E Kent; Janet S de Moor; Katherine S Virgo; Gery P Guy; Donatus U Ekwueme; Zhiyuan Zheng; Stephanie Nutt; Loyce Pace; Alexandra Varga; Lisa Waiwaiole; Jennifer Schneider; K Robin Yabroff Journal: J Cancer Surviv Date: 2017-08-29 Impact factor: 4.442
Authors: Matthew P Banegas; Gery P Guy; Janet S de Moor; Donatus U Ekwueme; Katherine S Virgo; Erin E Kent; Stephanie Nutt; Zhiyuan Zheng; Ruth Rechis; K Robin Yabroff Journal: Health Aff (Millwood) Date: 2016-01 Impact factor: 6.301