THE COSTS to treat blood cancer are higher than the costs to treat other cancers, and the costs incurred by a patient diagnosed with a blood cancer do not return to precancer levels, according to a Milliman study commissioned by The Leukemia & Lymphoma Society (LLS). The study—The Cost Burden of Blood Cancer Care1—offers new information on the cost of blood cancer care that can inform payers, providers, patients, patient advocates, and policymakers. Representatives from LLS and Milliman presented these findings at the 2018 Association for Value-Based Cancer Care Summit.
Gwen L. Nichols, MD
“We at LLS frequently hear from [patients with] blood cancer about the rising costs associated with life-saving treatment,” said Gwen L. Nichols, MD, LLS’s Chief Medical Officer. “As this new study shows, each player in the health-care system has a role to play in lowering these costs so patients can access their care.”
Key findings from the study include the following considerations:
- Blood cancer care is expensive for the health-care system. While the cost magnitude for treating blood cancer varies widely by blood cancer type, these costs, on average, are higher than the costs associated with treating nonblood cancers, even those with expensive treatment protocols. Further, average monthly health-care costs incurred by patients with blood cancer do not return to precancer spending levels.
- Services that drive spending within the broader health-care system differ from those that drive patient out-of-pocket costs. Across the full timeline of care, anticancer drug therapy is a key cost driver for the health-care system. Patient out-of-pocket costs, however, are mostly driven by professional services, a category that includes inpatient hospital or outpatient hospital encounters as well as office-based and other care services. Professional services are also responsible for the highest portion of costs associated with out-of-network care, which are associated with higher out-of-pocket costs patients pay when they use services outside their insurance plan’s coverage network.
- Very high spending occurs immediately following diagnosis. The month of diagnosis is the most expensive month for treating a blood cancer, primarily due to the costs associated with inpatient hospitalizations.
- Patient out-of-pocket costs are high and are impacted by insurance plan type and month of diagnosis. Out-of-pocket costs for blood cancer care average thousands of dollars per year and are strongly influenced by the patient’s insurance plan. Just as the costs to the health-care system are highest in the month of diagnosis, patient out-of-pocket costs are also highest at the onset of treatment.
LLS received support for this work from Pfizer, Genentech, and Amgen. ■
REFERENCE
1. Dieguez G, et al: The cost burden of blood cancer care. Available at www. lls.org/sites/default/files/Milliman%20study%20cost%20burden%20of%20 blood%20cancer%20care.pdf. Accessed November 15, 2018.
