OBJECTIVES

: We sought to determine if polypharmacy is associated with increased healthcare expenditures among cancer survivors in the U.S.

METHODS

: A cross-sectional study was conducted using the Medical Expenditure Panel Survey (MEPS), a set of surveys of non-institutionalized individuals, households, their medical providers and employers throughout the U.S. We included all adult patients with a primary diagnosis code for a single type of cancer, excluding nonmelanoma skin cancers, during even years 2008-2014. Polypharmacy was defined as the reported use of ≥ 5 distinct therapeutic classes of prescribed medication during the panel period. Healthcare expenditures were measured as the total direct payments per annum from all reported sources in 2017 dollars. We used ordinary least squares regression (OLS) with log transformed expenditures as our dependent variable adjusting for various demographic and clinical variables.

RESULTS

: Polypharmacy was present in 43.9% (10.6 million, weighted per year) of U.S. cancer survivors. The per annum total direct healthcare expenditures for all cancer survivors was approximately $162.6 billion. The mean annual adjusted healthcare expenditures per cancer survivor with polypharmacy was $13,266 (SD $3,766), which was significantly higher than those without polypharmacy $8,753 (SD $5,082, p-value <.0001) when controlling for age, insurance coverage, type of cancer, Elixhauser comorbidity score, number of provider encounters, and time since cancer diagnosis.

CONCLUSIONS : Cancer survivors with polypharmacy accounted for 70% of total annual direct healthcare expenditures among cancer survivors. Polypharmacy was associated with higher expenditures across cancer types, intensity of utilization, and setting of care.