Cost drivers of locally advanced rectal cancer treatment-An analysis of a leading healthcare insurer

J Surg Oncol. 2021 Mar;123(4):1023-1029. doi: 10.1002/jso.26390. Epub 2021 Jan 26.

Abstract

Background: To evaluate the economic burden of locally advanced rectal cancer (LARC) treatment from a society perspective through analysis of health insurance-derived data of commercially insured and Medicare Advantage (MA) patients.

Methods: Retrospective cost analysis of patients undergoing rectal resection within a multimodal (neoadjuvant chemoradiation + adjuvant chemotherapy) treatment strategy between January 1, 2010 and October 31, 2018, using the claims OptumLabs Data Warehouse database.

Results: In total, 1738 (935 commercial and 803 MA) patients were included. Overall treatment costs totaled $230,881,746 (on average $183 653 ± 82 384 per commercially insured and $73 681 ± 32 917 per MA patient). Cost distribution according to category (commercially insured patients) was: 29.92% related to outpatient care (follow-up visits/diagnostics), radiotherapy: 21.83%, index resection: 20.62%, chemotherapy: 17.44%, surgical inpatient: 6.32%, medical inpatient: 3.28%, emergency room: 0.58%. Relative cost distribution of the index resection itself differed marginally between the three approaches and was 21.49% for open, 19.30% for laparoscopic, and 20.93% for robotic surgery. Relative cost distributions of neoadjuvant, adjuvant, and outpatient treatments remained unchanged, independently of the surgical approach. This representation was similar in MA patients.

Conclusion: Index-surgery related costs were outweighed by costs related to oncological and outpatient workup/follow-up treatments independently of both surgical approach and insurance type.

Keywords: cost; multidisciplinary; rectal cancer treatment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy
  • Cost of Illness*
  • Female
  • Follow-Up Studies
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Insurance Carriers / statistics & numerical data*
  • Insurance, Health
  • Male
  • Medicare / statistics & numerical data*
  • Middle Aged
  • Neoadjuvant Therapy / economics*
  • Proctectomy / economics*
  • Prognosis
  • Rectal Neoplasms / economics*
  • Rectal Neoplasms / epidemiology
  • Rectal Neoplasms / therapy
  • Retrospective Studies
  • Survival Rate
  • United States / epidemiology
  • Young Adult