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American cancer patients spent more than $21 billion on their care in 2019, a new report shows.
That $21.09 billion included out-of-pocket costs of $16.22 billion and patient time costs of $4.87 billion. Patient time costs are the value of the time patients spend traveling for, waiting for and receiving care.
"As the costs of cancer treatment continue to rise, greater attention to addressing patient medical financial hardship, including difficulty paying medical bills, high levels of financial distress, and delaying care or forgoing care altogether because of cost, is warranted," said Karen Knudsen, chief executive officer of the American Cancer Society.
There was substantial variation in out-of-pocket costs, reflecting differences in treatment intensity and duration, as well as survival. Out-of-pocket costs were highest for breast ($3.14 billion), prostate ($2.26 billion), colon ($1.46 billion) and lung ($1.35 billion) cancers, reflecting higher rates of these cancers.
The report authors noted that it focused on direct costs to patients. The total overall costs of cancer care and lost productivity in the United States are much larger.
Among adults 65 and older with Medicare coverage, average annual out-of-pocket costs for medical services and prescription drugs were highest in the initial phase of care (first 12 months after diagnosis) — $2,200 and $243, respectively — and the end-of-life phase (12 months before death) — $3,823 and $448, respectively.
Patients originally diagnosed with localized cancer had lower average annual out-of-pocket costs for medical services during initial and end-of-life phases of care than those with more advanced cancer, according to Part 2 of the latest Annual Report to the Nation on the Status of Cancer. Part 1 was released in July and focused on national cancer statistics.
The new paper was published Oct. 26 in the Journal of the National Cancer Institute. It is a collaboration of the American Cancer Society, the U.S. Centers for Disease Control and Prevention, the U.S. National Cancer Institute (NCI) and the North American Association of Central Cancer Registries.
"These findings can help inform efforts to minimize the patient economic burden of cancer, and specific estimates may be useful in studies of the cost-effectiveness of interventions related to cancer prevention, diagnosis, treatment, and survivorship care," Knudsen said in a news release from the groups.
NCI director Dr. Norman Sharpless said in this modern era of cancer research it's important to think about treatment costs and how they impact patients.
"As exciting and promising as cancer research is, we are keenly aware of the issue of financial toxicity for these patients," Sharpless said.
"Therapies that are highly effective are no doubt good news, but if they are unaffordable it is not the total kind of progress we would like to see," Sharpless added. "Finding ways to ensure that not just some, but all, patients get access to therapies that are beneficial to them is an important goal we must continue to strive for in the cancer community. This report will help guide us toward achieving that goal."
The American Cancer Society offers advice on managing the costs of cancer treatment.
SOURCES: American Cancer Society; U.S. Centers for Disease Control and Prevention; U.S. National Cancer Institute; North American Association of Central Cancer Registries, news release, Oct. 26, 2021
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