Presentation (CTI)

OBJECTIVES: To assess the association between pain and healthcare expenditures among adults with cancer in the United States, and to quantify the extent to which sociodemographic and clinical characteristics explain observed cost differences.
METHODS: We used data from the Medical Expenditure Panel Survey (MEPS) for the period of 2019 to 2022, including adults (≥22 years) with a self-reported diagnosis of cancer (N=4,368). Pain status was defined based on patient-reported measures. We conducted weighted descriptive analyses and applied generalized linear models (GLM) with gamma distribution and log link to estimate incremental expenditures associated with pain. A Blinder-Oaxaca decomposition was used to partition the differences in total healthcare expenditures into explained and unexplained components.
RESULTS: Among cancer patients, 55.0% reported experiencing pain. Individuals with pain had significantly higher unadjusted total annual healthcare expenditures compared to those without pain ($22,072 vs. $13,366; p<0.0001). After adjusting for demographic, socioeconomic, and health status variables, pain remained significantly associated with higher total costs (incremental cost: $4,473; 95% CI: $1,010-$6,936; p=0.001), driven largely by inpatient, outpatient, prescription, and emergency services. Decomposition analysis indicated that 64.0% of the expenditure difference was explained by observed characteristics—most notably perceived health status and comorbidities (e.g., heart disease, COPD). The remaining 36.0% was unexplained, suggesting potential unmeasured disparities in care delivery or pain severity
CONCLUSIONS: Pain is associated with substantial increases in healthcare expenditures among individuals with cancer, even after accounting for differences in health and sociodemographic characteristics. These findings emphasize the need for targeted interventions and equitable pain management strategies to reduce economic burden and improve cancer care outcomes for those patients.