State-level cancer treatment costs: how much and who pays?

BACKGROUND

Cancer treatment accounts for approximately 5% of national health expenditures. However, no state-level estimates of cancer treatment costs have been published.

METHODS

In analyses of data from the Medical Expenditure Panel Survey, the National Nursing Home Survey, the U.S. Census Bureau, the Current Population Survey, and the Centers for Medicare & Medicaid Services, this study used regression modeling to estimate annual state-level cancer care costs during 2004 to 2008 for 4 categories of payers: all payers, Medicare, Medicaid, and private insurance.

RESULTS

State-level cancer care costs ranged from $227 million to $13.6 billion (median = $2.0 billion) in 2010 dollars. Medicare paid between 25.1% and 36.1% of these costs (median = 32.5%); private insurance paid between 36.0% and 49.6% (median = 43.3%); and Medicaid paid between 2.0% and 8.8% (median = 4.8%). Cancer treatment accounted for 3.8% to 8.7% of all state-level medical expenditures (median = 7.0%), 8.5% to 15.0% of state-level Medicare expenditures (median = 10.6%), 1.0% to 4.9% of state-level Medicaid expenditures (median = 2.2%), and 5.5% to 10.9% of state-level private insurance expenditures (median = 8.7%).

CONCLUSIONS

The costs of cancer treatment were substantial in all states and accounted for a sizable fraction of medical expenditures for all payers. The high cost of cancer treatment underscores the importance of preventing and controlling cancer as one approach to manage state-level medical costs.