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胰腺癌负担与疾病进展:美国的经济分析

Burden of pancreatic cancer and disease progression: economic analysis in the US.

作者信息

Chang Stella, Long Stacey R, Kutikova Lucie, Bowman Lee, Crown William H, Lyman Gary H

机构信息

Medstat Inc., Washington, DC 20008, USA.

出版信息

Oncology. 2006;70(1):71-80. doi: 10.1159/000091312. Epub 2006 Feb 6.

Abstract

OBJECTIVES

The few studies that have estimated the costs of pancreatic cancer were limited by small sample sizes, geography or patient age range. Using a large nationwide claims database, this study examines the cost of pancreatic cancer beginning with initial diagnosis and the additional costs when disease progresses.

METHODS

A retrospective cohort study was conducted using a claims database of 3 million individuals covered by large US employers. The study population consisted of patients newly diagnosed with pancreatic cancer in 1999-2000 and a demographically matched control group. Utilization and costs were summarized as monthly means. Changes in cancer severity and treatment over time were used to approximate disease progression and its associated costs.

RESULTS

The study included 412 pancreatic cancer patients and 1,236 controls. The mean follow-up time was 7.5 months. Regression-adjusted monthly costs attributable to pancreatic cancer were USD 7,279; over 60% resulted from hospitalizations. Patients with disease progression (over 50%) incurred an additional USD 15,143 per month compared to patients without disease progression.

CONCLUSION

Compared to patients without cancer, the costs of pancreatic cancer patients were substantial, especially when patients experienced disease progression. New therapies that prevent or delay disease progression could potentially offset the costs to patients, providers and society.

摘要

目的

少数估计胰腺癌成本的研究受到样本量小、地域或患者年龄范围的限制。本研究使用一个大型的全国性理赔数据库,从初始诊断开始考察胰腺癌的成本以及疾病进展时的额外成本。

方法

利用美国大型雇主承保的300万人的理赔数据库进行了一项回顾性队列研究。研究人群包括1999 - 2000年新诊断为胰腺癌的患者以及一个人口统计学匹配的对照组。利用情况和成本以月均值进行汇总。随着时间推移癌症严重程度和治疗的变化被用来估算疾病进展及其相关成本。

结果

该研究纳入了412例胰腺癌患者和1236例对照。平均随访时间为7.5个月。经回归调整后,胰腺癌每月的成本为7279美元;超过60%来自住院费用。与无疾病进展的患者相比,疾病进展的患者(超过50%)每月额外花费15143美元。

结论

与无癌症的患者相比,胰腺癌患者的成本很高,尤其是当患者经历疾病进展时。预防或延缓疾病进展的新疗法可能会抵消患者、医疗服务提供者和社会的成本。

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