TUESDAY, Jan. 2, 2007 (HealthDay News) -- The amount of time cancer patients spend traveling to, waiting for and receiving care is costly in terms of lost wages and other expenses, a new government study finds.
"For 2005, the estimated cost for the initial phase of care alone was approximately $2.3 billion" for U.S. cancer patients, concludes a report published in the Jan. 3 issue of the Journal of the National Cancer Institute.
That figure represents spending in the first year after diagnosis, an amount that rises rapidly as treatment continues in the years that follow.
"A lot of economists recommend that patient costs be included in determining cost effectiveness," said study author Robin Yabroff, an epidemiologist at the National Cancer Institute.
Yabroff and her colleagues used Medicare data on more than 760,000 patients with 11 different types of cancer. They estimated how long each patient spent traveling to, waiting for and receiving care. They then calculated the overall cost, using a value of $15.23 per hour -- the U.S. median wage in 2002.
Patients spent long hours seeking and undergoing treatment, but some malignancies required more time than others. Melanoma patients spent an average of 99 hours getting care during their illness, while individuals with lung and gastric cancers required an average of 488 and 512 hours of care, respectively.
In the case of colorectal cancer, patient's lost time accounted for 19 percent of total medical costs in the first year of diagnosis, rising to 37 percent in the last year, the researchers found.
Costs varied among different cancer types. For example, patient time costs for someone with melanoma averaged $271 during the first year after diagnosis and rose to $1,509 for the last year of life.
The first-year cost of time in treatment was highest for gastric cancer ($5,348) and ovarian cancer ($5,605), the researchers estimated. The costs rose to $7,799 for the last year of life of gastric cancer patients and $7,388 for the last year of ovarian cancer patients.
"We actually think these figures underestimate the costs, because they don't include such things as caregiver time," Yabroff said. "Caregivers for cancer patients tend to spend more time going to hospitals than other caregivers."
The numbers can be used when it comes to estimating the cost-effectiveness of cancer treatments, Yabroff said. "Say there is a new intervention for colon cancer," she said. "The time spent by the patient should be included in the overall cost of that care."
The size of the time costs as a proportion of total medical costs in cancer care comes as a surprise, said Larry G. Kessler, director of the office of science and engineering laboratory at the U.S. Food and Drug Administration and co-author of an accompanying editorial.
"We would have expected time costs to be a small proportion of overall costs," Kessler said. "Instead, it accounts for more than 33 percent."
The new estimates show that "we have greatly underestimated the true cost of the disease," the editorial said.
"This makes it all the more important for policy makers to change the pattern for health benefits," Kessler said. "We should focus more on early detection and also on therapies that can be delivered efficiently."
The finding also has implications for health insurers, Kessler said. "We suggest that insurance companies should think about incentives for early detection," he said.
The study results "should be used when evaluating new ways of prevention," said Dr. Christy A. Russell, an associate professor of medicine at the University of Southern California and chairwoman of the American Cancer Society's breast cancer advisory committee.
"I'm glad they pointed out that if we had better methods of prevention, or if the country would be willing to spend more dollars on the available methods of prevention, many of these personal costs could be avoided," Russell added.
More information
For most on cancer's financial cost, head to the American Cancer Society.
