Healthcare Costs of Cancer by Clinical Stage and Cost Component in a Private Health Plan in Brazil (Real World Data)

OBJECTIVES: The economic burden of cancer is a major issue worldwide. It´s estimated that the total cost of cancer to the global economy will reach 25.2 trillion dollars between 2020 and 2050 regarding 29 cancers 204 countries. The aim of this study is to measure 3-year care costs of 10 most common cancers disaggregated by clinical stage at diagnosis and treatment initiation.

METHODS: Retrospective non-interventional study using administrative database to identify 35–99 years patients diagnosed with one of the following cancers: breast, prostate, colon, rectum, lung, myeloma, ovary, bladder, pancreas, or stomach, from 2019 through 2022. Data gathered included TNM stage at diagnosis and treatment initiation. Analysis was carried out separately for each stage (I, II, III and IV) and by site. Follow-up for 36 months from diagnosis or until death. Resource utilizations and costs were evaluated by each patient, including chemotherapy and radiotherapy. Descriptive analysis of the cohorts was performed. Mann-Whitney test was used to compare the medians of the costs (significance level, p<0.05).

RESULTS: 543 patients diagnosed with one of the studied malignancies. Annualized average 3-year costs/patient stage I-III US$12,763 for initial period (diagnosis and treatment) and US$34,972 follow-up. Total survival-adjusted costs until death with stage IV (21.2%) were 49.8% higher than the 3-year costs for those with earlier-stage (p<0.001) (US$82,202/US$52,390). Most important cost component was chemotherapy for both groups (70.4% and 68.0% from total). There was considerable variation in costs by site. Stage IV cancers posed the greatest annual cost burden for different types of cancer.

CONCLUSIONS: A considerable difference in 3-year costs of cancer was found between stage IV at diagnosis and initiation of treatment patients when compared I to III stages. Results of this study emphasizes an urgent need for a robust worldwide investment in screening and early diagnosis of new cases of cancer.