Pancreatic cancer: total costs and utilization of health services.
OBJECTIVE
Pancreatic cancer ranks 11th in incidence, and fifth in cancer deaths, with 29,000 affected annually. Accurate estimates of the cost of pancreatic cancer are unavailable; existing estimates are variable or not generalizable. This paper presents detailed cost estimates for pancreatic cancer by service, age, and gender.


METHODS
Direct and indirect societal costs are determined using a prevalence-based, human capital approach.


RESULTS
Total annual costs are $4.9 billion, (men: $3.0 billion, women: $1.9 billion). Total direct costs are $881 million, with 71% ($627.1 M/$881.3 M) for those over 65 years. Total hospital costs are 77% ($679.5 M/$881.3 M) of total direct costs. Total indirect costs are $4.0 billion, with 63% ($2,518.43 M/$4,018 M) for those 45 to 64 years. Mortality costs are $3.7 billion, 93% ($3,739 M/$4,018 M) of indirect costs.


CONCLUSIONS
This paper presents cost estimates that are precise and generalizable to the general population. The surgical cost burden may be less than indicated previously, with most hospitalizations not including a major procedure, and average operating room costs accounting for only 9% ($1,045/$11,055) of hospital costs. Women have significantly less cancer-directed surgery than men.
Wilson
L S
LS
University of California, San Francisco, San Francisco, California 94143, USA. lwilson@itsa.ucsf.edu
Lightwood
J M
JM
D000367:Age Factors; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000191:economics / Q000706:statistics & numerical data; D006738:Hospices / Q000191:economics / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008134:Long-Term Care / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D010190:Pancreatic Neoplasms / Q000191:economics* / Q000453:epidemiology; D015995:Prevalence; D012737:Sex Factors