Nicole Mittmann1, Ning Liu2, Stephanie Y Cheng2, Soo Jin Seung2, Farah E Saxena2, Nicole J Look Hong2, Craig C Earle2, Matthew C Cheung2, Natasha B Leighl2, Natalie G Coburn2, Carlo DeAngelis2, William K Evans2. 1. Sunnybrook Research Institute (Mittmann, Seung) and Odette Cancer Centre (Look Hong, Earle, Cheung, Coburn, DeAngelis), Sunnybrook Health Sciences Centre; Cancer Care Ontario (Mittmann), Toronto, Ont.; Canadian Agency for Drugs and Technologies in Health (Mittmann), Ottawa, Ont.; ICES (Liu, Cheng, Saxena, Earle, Cheung, Coburn); Health Outcomes and PharmacoEconomic (HOPE) Research Centre (Seung); University Health Network (Leighl), Toronto, Ont.; McMaster University (Evans), Hamilton, Ont. nicole.mittmann@sunnybrook.ca. 2. Sunnybrook Research Institute (Mittmann, Seung) and Odette Cancer Centre (Look Hong, Earle, Cheung, Coburn, DeAngelis), Sunnybrook Health Sciences Centre; Cancer Care Ontario (Mittmann), Toronto, Ont.; Canadian Agency for Drugs and Technologies in Health (Mittmann), Ottawa, Ont.; ICES (Liu, Cheng, Saxena, Earle, Cheung, Coburn); Health Outcomes and PharmacoEconomic (HOPE) Research Centre (Seung); University Health Network (Leighl), Toronto, Ont.; McMaster University (Evans), Hamilton, Ont.
Abstract
BACKGROUND: Previous costing and resource estimates for cancer have not been complete owing to lack of comprehensive data on cancer-related medication and radiation treatment. Our objective was to calculate the mean overall costs per patient of cancer-related medications and radiation, as well as by disease subtype and stage, in the first year after diagnosis for the 4 most prevalent cancers in Ontario. METHODS: We conducted a retrospective cohort study using provincial health administrative databases to identify population health system resources and costs for all patients diagnosed with breast, colorectal, lung or prostate cancer between Jan. 1, 2010, and Dec. 31, 2015 in Ontario. The primary outcome measure was the overall average cost per patient in the 365 days after diagnosis for cancer-related medications and radiation treatment, calculated with the use of 2 novel costing algorithms. We determined the cost by disease, disease subtype and stage as secondary outcomes. RESULTS: There were 168 316 Ontarians diagnosed with cancer during the study period, 50 141 with breast cancer, 38 108 with colorectal cancer, 34 809 with lung cancer and 45 258 with prostate cancer. The mean per-patient cost for cancer-related medications was $8167 (95% confidence interval [CI] $8023-$8311), $6568 (95% CI $6446-$6691), $2900 (95% CI $2816-$2984) and $1211 (95% CI $1175-$1247) for breast, colorectal, lung and prostate cancer, respectively. The corresponding mean radiation treatment costs were $18 529 (95% CI $18 415-$18 643), $15 177 (95% CI $14 899-$15 456), $10 818 (95% CI $10 669-$10 966) and $16 887 (95% CI $16 648-$17 125). In general, stage III and IV cancers were the most expensive stages for both medications and radiation across all 4 disease sites. INTERPRETATION: Our work updates previous costing estimates to help understand costs and resources critical to health care system planning in a single-payer system. More refined costing estimates are useful as inputs to allow for more robust health economic modelling and health care system planning. Copyright 2020, Joule Inc. or its licensors.
BACKGROUND: Previous costing and resource estimates for cancer have not been complete owing to lack of comprehensive data on cancer-related medication and radiation treatment. Our objective was to calculate the mean overall costs per patient of cancer-related medications and radiation, as well as by disease subtype and stage, in the first year after diagnosis for the 4 most prevalent cancers in Ontario. METHODS: We conducted a retrospective cohort study using provincial health administrative databases to identify population health system resources and costs for all patients diagnosed with breast, colorectal, lung or prostate cancer between Jan. 1, 2010, and Dec. 31, 2015 in Ontario. The primary outcome measure was the overall average cost per patient in the 365 days after diagnosis for cancer-related medications and radiation treatment, calculated with the use of 2 novel costing algorithms. We determined the cost by disease, disease subtype and stage as secondary outcomes. RESULTS: There were 168 316 Ontarians diagnosed with cancer during the study period, 50 141 with breast cancer, 38 108 with colorectal cancer, 34 809 with lung cancer and 45 258 with prostate cancer. The mean per-patient cost for cancer-related medications was $8167 (95% confidence interval [CI] $8023-$8311), $6568 (95% CI $6446-$6691), $2900 (95% CI $2816-$2984) and $1211 (95% CI $1175-$1247) for breast, colorectal, lung and prostate cancer, respectively. The corresponding mean radiation treatment costs were $18 529 (95% CI $18 415-$18 643), $15 177 (95% CI $14 899-$15 456), $10 818 (95% CI $10 669-$10 966) and $16 887 (95% CI $16 648-$17 125). In general, stage III and IV cancers were the most expensive stages for both medications and radiation across all 4 disease sites. INTERPRETATION: Our work updates previous costing estimates to help understand costs and resources critical to health care system planning in a single-payer system. More refined costing estimates are useful as inputs to allow for more robust health economic modelling and health care system planning. Copyright 2020, Joule Inc. or its licensors.
Authors: N Mittmann; S Y Cheng; N Liu; S J Seung; F E Saxena; C DeAngelis; N J Look Hong; C C Earle; M C Cheung; N Leighl; N Coburn; W K Evans Journal: Curr Oncol Date: 2019-10-01 Impact factor: 3.677
Authors: Julio C Furlan; Kelvin K-W Chan; Guillermo A Sandoval; Kenneth C K Lam; Christopher A Klinger; Roy A Patchell; Audrey Laporte; Michael G Fehlings Journal: Neuro Oncol Date: 2012-04-14 Impact factor: 12.300
Authors: Rachel A Greenup; Rachel C Blitzblau; Kevin L Houck; Julie Ann Sosa; Janet Horton; Jeffrey M Peppercorn; Alphonse G Taghian; Barbara L Smith; E Shelley Hwang Journal: J Oncol Pract Date: 2017-03-14 Impact factor: 3.840
Authors: Nicole Mittmann; Craig C Earle; Stephanie Y Cheng; Jim A Julian; Farah Rahman; Soo Jin Seung; Mark N Levine Journal: J Clin Oncol Date: 2017-12-01 Impact factor: 44.544
Authors: Claire de Oliveira; Karen E Bremner; Reka Pataky; Nadia Gunraj; Kelvin Chan; Stuart Peacock; Murray D Krahn Journal: CMAJ Open Date: 2013-01-16
Authors: Claire de Oliveira; Reka Pataky; Karen E Bremner; Jagadish Rangrej; Kelvin K W Chan; Winson Y Cheung; Jeffrey S Hoch; Stuart Peacock; Murray D Krahn Journal: BMC Cancer Date: 2016-10-18 Impact factor: 4.430
Authors: Christine Brezden-Masley; Kelly E Fathers; Megan E Coombes; Behin Pourmirza; Cloris Xue; Katarzyna J Jerzak Journal: Breast Cancer Res Treat Date: 2020-10-16 Impact factor: 4.872
Authors: Teresa C O Tsui; Maureen Trudeau; Nicholas Mitsakakis; Sofia Torres; Karen E Bremner; Doyoung Kim; Aileen M Davis; Murray D Krahn Journal: PLoS One Date: 2022-02-04 Impact factor: 3.240
Authors: Christine Brezden-Masley; Kelly E Fathers; Megan E Coombes; Behin Pourmirza; Cloris Xue; Katarzyna J Jerzak Journal: Breast Cancer Res Treat Date: 2020-10-22 Impact factor: 4.872