Claire de Oliveira1, Karen E Bremner2, Ning Liu3, Mark L Greenberg4, Paul C Nathan5, Mary L McBride6, Murray D Krahn7. 1. Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. 2. Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada. Electronic address: kbremner@uhnresearch.ca. 3. Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. 4. Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada; Hospital for Sick Children, Toronto, Ontario, Canada. 5. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Hospital for Sick Children, Toronto, Ontario, Canada. 6. British Columbia Cancer Agency, Vancouver, British Columbia, Canada; University of British Columbia, Vancouver, British Columbia, Canada. 7. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada; Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Abstract
BACKGROUND: Childhood and adolescent cancers are uncommon, but they have important economic and health impacts on patients, families, and health care systems. Few studies have measured the economic burden of care for childhood and adolescent cancers. OBJECTIVES: To estimate costs of cancer care in population-based cohorts of children and adolescents from the public payer perspective. METHODS: We identified patients with cancer, aged 91 days to 19 years, diagnosed from 1995 to 2009 using cancer registry data, and matched each to three noncancer controls. Using linked administrative health care records, we estimated total and net resource-specific costs (in 2012 Canadian dollars) during 90 days prediagnosis and 1 year postdiagnosis. RESULTS: Children (≤14 years old) numbered 4,396: 36% had leukemia, 21% central nervous system tumors, 10% lymphoma, and 33% other cancers. Adolescents (15-19 years old) numbered 2,329: 28.9% had lymphoma. Bone and soft tissue sarcoma, germ cell tumor, and thyroid carcinoma each comprised 12% to 13%. Mean net prediagnosis costs were $5,810 and $1,127 and mean net postdiagnosis costs were $136,413 and $62,326 for children and adolescents, respectively; the highest were for leukemia ($157,764 for children and $172,034 for adolescents). In both cohorts, costs were much higher for patients who died within 1 year of diagnosis. Inpatient hospitalization represented 69% to 74% of postdiagnosis costs. CONCLUSIONS: Treating children with cancer is costly, more costly than treating adolescents or adults. Substantial survival gains in children mean that treatment may still be very cost-effective. Comprehensive age-specific population-based cost estimates are essential to reliably assess the cost-effectiveness of cancer care for children and adolescents, and measure health system performance.
BACKGROUND: Childhood and adolescent cancers are uncommon, but they have important economic and health impacts on patients, families, and health care systems. Few studies have measured the economic burden of care for childhood and adolescent cancers. OBJECTIVES: To estimate costs of cancer care in population-based cohorts of children and adolescents from the public payer perspective. METHODS: We identified patients with cancer, aged 91 days to 19 years, diagnosed from 1995 to 2009 using cancer registry data, and matched each to three noncancer controls. Using linked administrative health care records, we estimated total and net resource-specific costs (in 2012 Canadian dollars) during 90 days prediagnosis and 1 year postdiagnosis. RESULTS:Children (≤14 years old) numbered 4,396: 36% had leukemia, 21% central nervous system tumors, 10% lymphoma, and 33% other cancers. Adolescents (15-19 years old) numbered 2,329: 28.9% had lymphoma. Bone and soft tissue sarcoma, germ cell tumor, and thyroid carcinoma each comprised 12% to 13%. Mean net prediagnosis costs were $5,810 and $1,127 and mean net postdiagnosis costs were $136,413 and $62,326 for children and adolescents, respectively; the highest were for leukemia ($157,764 for children and $172,034 for adolescents). In both cohorts, costs were much higher for patients who died within 1 year of diagnosis. Inpatient hospitalization represented 69% to 74% of postdiagnosis costs. CONCLUSIONS: Treating children with cancer is costly, more costly than treating adolescents or adults. Substantial survival gains in children mean that treatment may still be very cost-effective. Comprehensive age-specific population-based cost estimates are essential to reliably assess the cost-effectiveness of cancer care for children and adolescents, and measure health system performance.
Authors: Isabella Lima Arrais Ribeiro; Ricardo Dias de Castro; Raphael Cavalcante Costa; Lecidâmia Cristina Leite Damascena; Nyellisonn Nando Nóbrega de Lucena; Paula Maria Bezerra Maracajá; Fabio Gomes Dos Santos; Eliane Batista de Medeiros Serpa; Simone Alves Sousa; Ana Maria Gondim Valença Journal: Eur J Pediatr Date: 2021-03-22 Impact factor: 3.183
Authors: Paul C Nathan; Karen E Bremner; Ning Liu; Sumit Gupta; Mark L Greenberg; Mary L McBride; Murray D Krahn; Claire de Oliveira Journal: J Natl Cancer Inst Date: 2019-03-01 Impact factor: 13.506
Authors: Wonjeong Chae; Juyeong Kim; Sohee Park; Eun-Cheol Park; Sung-In Jang Journal: Int J Environ Res Public Health Date: 2020-08-19 Impact factor: 3.390
Authors: Claire de Oliveira; Alison Macpherson; Charlotte Moore Hepburn; Anjie Huang; Rachel Strauss; Ning Liu; Lisa Fiksenbaum; Paul Pageau; David Gomez; Natasha Ruth Saunders Journal: Eur J Pediatr Date: 2022-03-05 Impact factor: 3.860
Authors: Teresa C O Tsui; Seraphine Zeitouny; Karen E Bremner; Douglas C Cheung; Carol Mulder; Ruth Croxford; Lisa Del Giudice; Lauren Lapointe-Shaw; Andrew Mendlowitz; William W L Wong; Nathan Perlis; Beate Sander; Paulos Teckle; George Tomlinson; Jennifer D Walker; Kamil Malikov; Kimberlyn M McGrail; Stuart Peacock; Girish S Kulkarni; Reka E Pataky; Murray D Krahn Journal: CMAJ Open Date: 2022-09-20
Authors: Mary L McBride; Claire de Oliveira; Ross Duncan; Karen E Bremner; Ning Liu; Mark L Greenberg; Paul C Nathan; Paul C Rogers; Stuart J Peacock; Murray D Krahn Journal: Healthc Policy Date: 2020-02