Abstract
Background
Gastrointestinal cancers contribute substantially to the cost of health care. We sought
to quantify and compare the financial burden associated with treatment of gastrointestinal
cancers versus other common nongastrointestinal cancers.
Methods
The Medical Expenditure Panel Survey from 2006 to 2015 was used to identify individuals
with gastrointestinal cancer, other nongastrointestinal cancer (breast/prostate or
lung), or no history of malignancy. Total and out-of-pocket medical expenditures were
compared. Among each cohort, risk of high and catastrophic financial burden was determined.
Results
A total of 90,344 individuals were identified, which was extrapolated to a national
representative sample of 95,449,062 individuals. Overall, an estimated 365,367 (0.4%)
individuals had a gastrointestinal cancer while 2,015,724 (2.1%) had lung, breast,
or prostate cancer. Mean adjusted total health expenditures was greater among patients
with gastrointestinal cancer ($13,716; 95% confidence interval, $9,805–$17,628) versus
patients with nongastrointestinal cancer ($8,665; 95% confidence interval, $8,222–$9,108)
or individuals without cancer ($5,807; 95% confidence interval $5,740–$5,874). An
estimated 15.8% (n = 57,898) and 7.1% (n = 25,956) of patients with gastrointestinal cancer experienced a high and catastrophic
financial burden, respectively. Patients with gastrointestinal cancer had a 64% increased
odds of experiencing catastrophic financial burden compared with patients without
a history of cancer (odds ratio 1.64, 95% confidence interval, 1.17–2.31). Furthermore,
patients with a gastrointestinal cancer had nearly 40% increased odds of high financial
burden associated with their care compared with patients without cancer (odds ratio
1.37; 95% confidence interval, 1.00–1.88).
Conclusion
The risk of experiencing catastrophic financial burden among patients with gastrointestinal
cancer was considerable, as roughly 1 in 7 patients experienced high financial burden,
and 1 in 13 had a catastrophic financial burden.
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Article info
Publication history
Published online: April 15, 2020
Accepted:
February 26,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
