Annual Healthcare Costs Higher for Survivors

Each year, adult cancer survivors spend, on average, $4000 to $5000 more on total medical expenditures than people who have never had cancer, according to a study of survivors younger than 65 years. “These ongoing expenditures signal what oncology nurses already know…when people finish their treatment for cancer, that is not necessarily the end of it. They require ongoing support. There’s a need for heightened surveillance that extends for the rest of their lives. Perhaps they’ll need other kinds of services, too,” lead author Pamela Farley Short, PhD, tells the Academy of Oncology Nurse Navigators.

Using the National Cancer Institute’s definition of cancer survivor—from diagnosis through end of life—investigators at Penn State University focused on prime-age survivors because this population has been underrepresented in previous research, yet the implications of the economic impact upon them can help inform the national health reform debate. “To my way of thinking, cancer survivors are poster children for healthcare reform,” says Short. “It is people like cancer survivors who will particularly benefit from the new system where people are guaranteed insurance at an affordable price, and moving away from a system where their health history can affect what they have to pay for insurance.”

Short and colleagues analyzed annual expenditures for newly diagnosed survivors (in that calendar year), previously diagnosed survivors (in a previous calendar year), and those with no history of cancer. Although the high cost for newly diagnosed survivors is expected (as they undergo active treatment), the financial burden for longer-term survivors remains significant. They found that survivors 1 to 5 years after diagnosis averaged almost $6000 more per year than people with no history of cancer, and survivors >5 years after diagnosis averaged $4000 more.

Separating out cancer-related ex - penses from those for comorbid conditions reduced the estimates by approximately $1000. Prescription costs contributed particularly to expenses paid out of pocket (OOP) by survivors, accounting for 44% of the total.

For many, the additional economic burden of cancer survivorship is covered by public or private insurance. But not for all. The investigators identified uneven distribution of OOP expenses. For example in survivors aged between 40 and 64 years, approximately 60% spent ≤$1000 per year OOP, but 5% spent >$5000 per year OOP.

“I think it goes to show that having good insurance is particularly important for survivors. Those who find themselves without access to good health insurance for some reason are at a disadvantage compared with other people,” shares Short, highlighting the public health implications of the findings. Prescription coverage, in particular, “is an area where there is a lot more variation among private health insurance plans in terms of how well they cover specific drugs and whether they cover some drugs at all.”