Claire de Oliveira1,2,3,4, Karen E Bremner5, Ning Liu4, Mark L Greenberg6,7, Paul C Nathan2,7, Mary L McBride8,9, Murray D Krahn2,3,4,5,10,11. 1. Centre for Addiction and Mental Health, Toronto, Ontario, Canada. 2. Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada. 3. Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, Canada. 4. Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. 5. Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada. 6. Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada. 7. Department of Pediatrics, Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada. 8. Cancer Control Research Program, British Columbia Cancer Agency, Vancouver, British Columbia, Canada. 9. School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada. 10. Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada. 11. Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Abstract
BACKGROUND: Cancer in children and adolescents presents unique issues regarding treatment and survivorship, but few studies have measured economic burden. We estimated health care costs by phase of cancer care, from the public payer perspective, in population-based cohorts. METHODS: Children newly diagnosed at ages 0 days-14.9 years and adolescents newly diagnosed at 15-19.9 years, from January 1, 1995 to June 30, 2010, were identified from Ontario cancer registries, and each matched to three noncancer controls. Data were linked with administrative records describing resource use for cancer and other health care. Total and net (patients minus controls) resource-specific costs ($CAD2012) were estimated using generalized estimating equations for four phases of care: prediagnosis (60 days), initial (360 days), continuing (variable), final (360 days). RESULTS: Mean ages at diagnosis were 6 years for children (N = 4,606) and 17 years for adolescents (N = 2,443). Mean net prediagnosis phase 60-day costs were $6,177 for children and $1,018 for adolescents. Costs for initial, continuing, and final phases were $138,161, $15,756, and $316,303 per 360 days for children, and $62,919, $7,071, and $242,008 for adolescents. The highest initial phase costs were for leukemia patients ($156,225 per 360 days for children and $171,275 for adolescents). The final phase was the most costly ($316,303 per 360 days for children and $242,008 for adolescents). CONCLUSIONS: Costs for children with cancer are much higher than for adolescents and much higher than those reported in adults. Comprehensive population-based long-term estimates of cancer costs are useful for health services planning and cost-effectiveness analysis.
BACKGROUND:Cancer in children and adolescents presents unique issues regarding treatment and survivorship, but few studies have measured economic burden. We estimated health care costs by phase of cancer care, from the public payer perspective, in population-based cohorts. METHODS:Children newly diagnosed at ages 0 days-14.9 years and adolescents newly diagnosed at 15-19.9 years, from January 1, 1995 to June 30, 2010, were identified from Ontario cancer registries, and each matched to three noncancer controls. Data were linked with administrative records describing resource use for cancer and other health care. Total and net (patients minus controls) resource-specific costs ($CAD2012) were estimated using generalized estimating equations for four phases of care: prediagnosis (60 days), initial (360 days), continuing (variable), final (360 days). RESULTS: Mean ages at diagnosis were 6 years for children (N = 4,606) and 17 years for adolescents (N = 2,443). Mean net prediagnosis phase 60-day costs were $6,177 for children and $1,018 for adolescents. Costs for initial, continuing, and final phases were $138,161, $15,756, and $316,303 per 360 days for children, and $62,919, $7,071, and $242,008 for adolescents. The highest initial phase costs were for leukemiapatients ($156,225 per 360 days for children and $171,275 for adolescents). The final phase was the most costly ($316,303 per 360 days for children and $242,008 for adolescents). CONCLUSIONS: Costs for children with cancer are much higher than for adolescents and much higher than those reported in adults. Comprehensive population-based long-term estimates of cancer costs are useful for health services planning and cost-effectiveness analysis.
Authors: Katharina M D Merollini; Louisa G Gordon; Joanne F Aitken; Michael G Kimlin Journal: Int J Environ Res Public Health Date: 2020-04-20 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: 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