HEALTH CARE RESOURCE UTILIZATION AND COST INCURRED IN PATIENTS WITH MULTIPLE CANCERS: EVIDENCE FROM THE MEDICAL EXPENDITURE PANEL SURVEY
Author(s)
Gerald O. Ozota, BPharm, Lawrence Brown, PhD;
Chapman University School of Pharmacy, Pharmaceutical Economics and Policy, Irvine, CA, USA
Chapman University School of Pharmacy, Pharmaceutical Economics and Policy, Irvine, CA, USA
OBJECTIVES: Patients with multiple co-existing primary cancers often experience greater clinical complexity, yet evidence on their healthcare utilization and cost burden in the United States remains limited. This study evaluates all-cause and cancer-attributable healthcare resource utilization (HCRU) and costs among adults with two or more distinct malignant cancer sites versus those with one cancer site in the U.S.
METHODS: We conducted a cross-sectional analysis of adults aged 18 years or older using the 2018-2023 Medical Expenditure Panel Survey (MEPS). Malignant cancers were identified from condition records using ICD-10 C-codes, grouped by anatomic site; patients were classified as having multi-site cancer if they had ≥2 distinct sites recorded within a survey year. Outcomes were measured as per-patient-per-month (PPPM) values: all-cause total costs, cancer-attributable costs (event-linked expenditures), emergency department (ED) visits, inpatient stays, and prescription fills. Survey-weighted means, medians, and 95% confidence intervals were estimated using Taylor-series methods. We compared outcomes by multi-site cancer status and adjusted estimates for age, education, and cost-related care delays.
RESULTS: Among approximately 151,452 weighted person-years, 8.73% involved ≥1 malignant cancer diagnosis, and 0.34% had ≥2 distinct cancer sites. Compared with individuals with 0-1 cancer sites, those with multi-site cancer exhibited substantially higher HCRU and costs. Mean adjusted PPPM total expenditures were approximately $2,988 vs $611.3 (p<0.001), and mean PPPM cancer-attributable expenditures were $836.6 vs $18.9 (p<0.001). Multi-site cancer was also associated with greater ED visits (0.036 vs 0.016 PPPM), inpatient stays (0.026 vs 0.007 PPPM), and prescription use (2.17 vs 0.75 PPPM). Cost distributions were right-skewed, with medians lower than means but showing the same pattern.
CONCLUSIONS: U.S. adults with multiple co-existing cancers experience markedly higher healthcare utilization and monthly expenditures, particularly for inpatient care and cancer-attributable services. These findings highlight the need for coordinated care pathways, financial toxicity mitigation, and improved survivorship planning for patients with multiple malignancies.
METHODS: We conducted a cross-sectional analysis of adults aged 18 years or older using the 2018-2023 Medical Expenditure Panel Survey (MEPS). Malignant cancers were identified from condition records using ICD-10 C-codes, grouped by anatomic site; patients were classified as having multi-site cancer if they had ≥2 distinct sites recorded within a survey year. Outcomes were measured as per-patient-per-month (PPPM) values: all-cause total costs, cancer-attributable costs (event-linked expenditures), emergency department (ED) visits, inpatient stays, and prescription fills. Survey-weighted means, medians, and 95% confidence intervals were estimated using Taylor-series methods. We compared outcomes by multi-site cancer status and adjusted estimates for age, education, and cost-related care delays.
RESULTS: Among approximately 151,452 weighted person-years, 8.73% involved ≥1 malignant cancer diagnosis, and 0.34% had ≥2 distinct cancer sites. Compared with individuals with 0-1 cancer sites, those with multi-site cancer exhibited substantially higher HCRU and costs. Mean adjusted PPPM total expenditures were approximately $2,988 vs $611.3 (p<0.001), and mean PPPM cancer-attributable expenditures were $836.6 vs $18.9 (p<0.001). Multi-site cancer was also associated with greater ED visits (0.036 vs 0.016 PPPM), inpatient stays (0.026 vs 0.007 PPPM), and prescription use (2.17 vs 0.75 PPPM). Cost distributions were right-skewed, with medians lower than means but showing the same pattern.
CONCLUSIONS: U.S. adults with multiple co-existing cancers experience markedly higher healthcare utilization and monthly expenditures, particularly for inpatient care and cancer-attributable services. These findings highlight the need for coordinated care pathways, financial toxicity mitigation, and improved survivorship planning for patients with multiple malignancies.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE465
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology