Phase-Based and Lifetime Health System Costs of Care for Patients Diagnosed with Leukemia and Lymphoma: A Population-Based Descriptive Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Participants
2.2. Data Sources
- Inpatient costs: Includes hospitalization-related costs.
- Outpatient costs: Includes general outpatient clinic costs.
- Physician services cost: Includes physician fees (including outpatient visits), shadow billings, and capitation payments.
- Prescription drug costs: Includes the costs of drugs covered under the ODB programme. ODB covers prescription drugs for patients meeting certain criteria including, age (65+ years), income, and residency status.
- Specialized cancer drug costs: Includes the costs of drugs that are covered under NDFP and includes intravenous systemic chemotherapy drugs.
- Emergency department, same-day surgery, and ambulatory care costs: refer to the costs incurred from same-day surgery visits, emergency department visits, and high-cost ambulatory care visits to the dialysis clinics and cancer clinics. This does not include physician billings incurred during any of the abovementioned visits.
- Home and community care costs: Includes the costs incurred from home care services, rehabilitation, complex and continuing care, and long-term care costs.
- Other costs: Includes laboratory billings, non-physician billings, and assisted device costs.
2.3. Cost Estimation
2.4. Statistical Analysis
- The initial phase: the first 9 months immediately after diagnosis;
- The terminal phase: 3 months before death;
- The continuing phase: time between the initial and terminal phase.
3. Results
3.1. Patient Characteristics
3.2. Phase-Specific Mean Monthly Costs
3.2.1. Prediagnosis Phase
3.2.2. Initial Phase
3.2.3. Continuing Phase
3.2.4. Terminal Phase
3.2.5. Trends in Phase-Specific Mean Monthly Costs
3.3. Component Contribution in Phase-Specific Costs
3.4. Lifetime Costs
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | Lymphoma | Leukemia | ||
---|---|---|---|---|
Number | Percent | Number | Percent | |
Overall sample | 47,255 | 100 | 26,846 | 100 |
Type of cancer | ||||
Hodgkin lymphoma | 5233 | 11.1 | ||
Non-Hodgkin lymphoma | 42,022 | 88.9 | ||
Acute lymphocytic leukemia | 2694 | 10.0 | ||
Chronic lymphocytic leukemia | 10,830 | 40.3 | ||
Acute myeloid leukemia | 6553 | 24.4 | ||
Chronic myeloid leukemia | 3405 | 12.7 | ||
Other leukemias | 3364 | 12.5 | ||
Median age at diagnosis in years (Q1, Q3) | 64.0 (51.0, 75.0) | 66.0 (53.0, 77.0) | ||
Sex | ||||
Male | 25,805 | 54.6 | 15,531 | 57.9 |
Female | 21,450 | 45.4 | 11,315 | 42.1 |
Neighbourhood income quintile | ||||
1—Low | 8682 | 18.5 | 5242 | 19.6 |
2 | 9456 | 20.1 | 5394 | 20.2 |
3 | 9224 | 19.6 | 5199 | 19.4 |
4 | 9491 | 20.2 | 5421 | 20.2 |
5—High | 10,188 | 21.7 | 5497 | 20.6 |
Rural residence | 5916 | 12.5 | 3614 | 13.5 |
Died during follow-up | 18,759 | 39.7 | 12,916 | 48.1 |
Median follow-up time in days (Q1, Q3) | 47,255 | 1603.0 (582.0, 3061.0) | 26,846 | 1327.5 (383.0, 2837.0) |
Year of diagnosis | ||||
2005 | 2424 | 5.1 | 1480 | 5.5 |
2006 | 2461 | 5.2 | 1526 | 5.7 |
2007 | 2612 | 5.5 | 1683 | 6.3 |
2008 | 2633 | 5.6 | 1651 | 6.1 |
2009 | 2608 | 5.5 | 1701 | 6.3 |
2010 | 2983 | 6.3 | 1946 | 7.2 |
2011 | 3019 | 6.4 | 1793 | 6.7 |
2012 | 3286 | 7.0 | 1740 | 6.5 |
2013 | 3440 | 7.3 | 1888 | 7.0 |
2014 | 3447 | 7.3 | 1934 | 7.2 |
2015 | 3405 | 7.2 | 1961 | 7.3 |
2016 | 3736 | 7.9 | 1813 | 6.8 |
2017 | 3741 | 7.9 | 1921 | 7.2 |
2018 | 3694 | 7.8 | 1909 | 7.1 |
2019 | 3766 | 8.0 | 1900 | 7.1 |
Cancer Subtype | n | Number of Months in Phase | Cost by Phase | Lifetime Cost | ||||
---|---|---|---|---|---|---|---|---|
Initial | Continuing | Terminal | Initial | Continuing | Terminal | |||
Hodgkin lymphoma | 5233 | 8.66 (8.62–8.70) | 84.49 (82.98–85.99) | 2.72 (2.68–2.77) | 53,832 (52,632–55,033) | 198,747 (185,322–212,172) | 15,604 (14,727–16,481) | 268,184 (252,681–283,687) |
Non-Hodgkin lymphoma | 42,022 | 8.42 (8.40–8.44) | 67.54 (67.02–68.07) | 2.57 (2.56–2.58) | 55,233 (54,613–55,853) | 226,450 (221,942–230,958) | 40,151 (39,604–40,699) | 321,834 (316,159–327,510) |
Acute lymphocytic leukemia | 2694 | 8.6 (8.54–8.67) | 80.06 (77.84–82.27) | 2.51 (2.44–2.58) | 157,173 (153,959–160,386) | 588,158 (551,397–624,918) | 33,464 (31,689–35,240) | 778,795 (737,045–820,544) |
Chronic lymphocytic leukemia | 10,830 | 8.74 (8.71–8.76) | 71.43 (70.49–72.37) | 2.80 (2.78–2.82) | 19,075 (18,291–19,860) | 214,484 (208,500–220,469) | 29,023 (28,003–30,043) | 262,583 (254,794–270,372) |
Acute myeloid leukemia | 6553 | 7.34 (7.26–7.43) | 47.13 (45.41–48.86) | 2.27 (2.24–2.30) | 98,752 (96,759–100,745) | 314,499 (299,884–329,115) | 65,264 (63,768–66,761) | 478,516 (460,411–496,620) |
Chronic myeloid leukemia | 3405 | 8.4 (8.33–8.46) | 64.17 (62.28–66.05) | 2.69 (2.65–2.73) | 37,317 (35,588–39,046) | 371,618 (352,728–390,508) | 35,932 (34,168–37,697) | 444,867 (422,484–467,251) |
Other leukemia | 3364 | 8.29 (8.21–8.37) | 65.41 (63.35–67.48) | 2.04 (1.98–2.09) | 41,867 (39,474–44,260) | 207,872 (191,328–224,416) | 43,189 (41,336–45,042) | 292,929 (272,139–313,719) |
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Agarwal, A.; Kekre, N.; Atkins, H.; Imsirovic, H.; Hutton, B.; Coyle, D.; Thavorn, K. Phase-Based and Lifetime Health System Costs of Care for Patients Diagnosed with Leukemia and Lymphoma: A Population-Based Descriptive Study. Curr. Oncol. 2024, 31, 4192-4208. https://doi.org/10.3390/curroncol31080313
Agarwal A, Kekre N, Atkins H, Imsirovic H, Hutton B, Coyle D, Thavorn K. Phase-Based and Lifetime Health System Costs of Care for Patients Diagnosed with Leukemia and Lymphoma: A Population-Based Descriptive Study. Current Oncology. 2024; 31(8):4192-4208. https://doi.org/10.3390/curroncol31080313
Chicago/Turabian StyleAgarwal, Anubhav, Natasha Kekre, Harold Atkins, Haris Imsirovic, Brian Hutton, Doug Coyle, and Kednapa Thavorn. 2024. "Phase-Based and Lifetime Health System Costs of Care for Patients Diagnosed with Leukemia and Lymphoma: A Population-Based Descriptive Study" Current Oncology 31, no. 8: 4192-4208. https://doi.org/10.3390/curroncol31080313
APA StyleAgarwal, A., Kekre, N., Atkins, H., Imsirovic, H., Hutton, B., Coyle, D., & Thavorn, K. (2024). Phase-Based and Lifetime Health System Costs of Care for Patients Diagnosed with Leukemia and Lymphoma: A Population-Based Descriptive Study. Current Oncology, 31(8), 4192-4208. https://doi.org/10.3390/curroncol31080313