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Frank J Papatheofanis, Bonnie M Korenblat Donato, Patricia Grossman, Raafat Seifeldin, UCSD/ Aequitas Consulting Group, San Diego, CA; Bristol-Myers Squibb Company, Wallingford, CT.
Abstract:
Purpose: To measure the cost-of-care associated with treating gastric and esophageal cancer [GEJ] in the in- and out-patient setting and identify associated economic determinants of care. Direct medical costs associated with cancer was $60 billion US in 2000. Methods: Billing records from NCI comprehensive centers and affiliated community clinics were reviewed in 156 patients with gastric [Stage II-IV] and 119 patients with GEJ [Stage II-IV] cancer. Markov modeling was used to depict gastric cancer disease management scenarios for each stage using a 65 year old male as the base case. Medicare charges were used as surrogates of cost. Regression analysis identified cost drivers. Results: All costs reported are in 2000 USD. Median in-patient cost range per patient per year for gastric cancers is: Stage II- $29841-30957; Stage III- $40019-41093; Stage IV- $41584-45025. GEJ cancer: Stage II-$29074-36524; Stage III- $34538-38452; Stage IV- $40898-41946. Median out-patient cost range per patient per year for gastric cancers is: Stage II- $3454-5636; Stage III- $4843-6412; Stage IV- $9563-12947; for GEJ cancer: Stage II-$3288-4538; Stage III- $4000-5394; Stage IV- $10375-11857. Procedures including esophagoscopy, surgical resection, neoadjuvant CXT, and RT were cost drivers of care. Length of stay (LOS) and number of outpatient visits were cost savers. Conclusion: Procedures increased costs associated with gastric cancer treatment while LOS and OP visits produced cost savings. Findings suggest repeated out-patient visits and in-patient care produce cost savings in the management of gastric cancer patients.
Associated Presentation(s):
1. Economic determinants of gastric cancer and malignancies of the gastroesophageal junction in the in- and out-patient setting
Associated Presentation(s):