Valuing Supportive-Care Interventions

The Economics of Cancer-Related Symptoms: Valuing Supportive-Care Interventions

Introduction

Health care costs in the United States have been rising for years. Expenditures for health care in the United States grew 6.1% to $2.2 trillion in 2007, when US health care spending was about $7421 per person and accounted for 16.2% of gross domestic product.1 These rising costs are due in part to the aging population, longer life spans, and greater prevalence of chronic illnesses.

Cancer is one of the most expensive health conditions. More than 1.4 million new cases of invasive cancer and another 1.0 million cases of basal cell and squamous cell skin cancer are projected to be diagnosed in 20082; the overall cost of cancer in 2007, as estimated by the National Institutes of Health, was $219.2 billion, including $89.0 billion for direct medical costs (total of all health expenditures) and $18.2 billion for indirect morbidity costs (cost of lost productivity as a result of illness).2

The financial costs of cancer care are substantial, both from a societal perspective and from an individual perspective. Not only is cancer treatment expensive, but the economic burden of diagnosis and supportive care to meet patient needs throughout survival and at the end of life is also considerable. It is important to realize that over the years there has been an improvement in cancer survival, with 66% of patients with cancer surviving for at least five years.2 The consideration that extended survival is only as good as the quality of the life it prolongs has engendered increased attention to economic factors related to the supportive care of patients with cancer.

Supportive care for patients with cancer encompasses a wide range of symptoms and conditions, ranging from less-severe issues such as nausea, vomiting, and anemia to more-severe and complex issues such as mucositis, febrile neutropenia, and pulmonary embolism. The treatments and costs for such supportive care are equally...