The economic burden of supportive care of cancer patients.
OBJECTIVE
Economic and regulatory healthcare policy is limited by the lack of population-based information on the cost of supportive care of cancer patients. The goal of this study was to estimate these costs and to explore the impact of these costs on policy decisions.


METHODS
We identified estimates of the cost of outpatient and inpatient supportive care from published reports in the literature. The range of these costs (from lowest to highest) is described for each supportive care condition. These estimates were supplemented by computing the cost of all hospitalizations for these conditions in Texas between June 2000 and December 2001. Medicare payments were used to estimate average reimbursement. Costs (not charges) were standardized to 2002 US dollars using the consumer price index for medical care and Medicare's cost-to-charge ratio for Texas.


RESULTS
Inpatient care for most conditions exceeded 7,000 US dollars per episode. Our population-based estimates of the cost of care were similar to literature-based estimates, except in the case where conditions could be managed in the outpatient setting. Average Medicare payments were often far lower than the estimated cost of care. For example, the estimated cost of hospitalization for management of diarrhea was 6,616 US dollars while the average Medicare payment was only 2,809 US dollars.


CONCLUSIONS
Many supportive care interventions are quite expensive. In an environment focused on cost containment, a risk-based approach to expensive supportive care treatments is essential. Further study of the cost effectiveness of supportive care management strategies is indicated.
Elting
Linda S
LS
Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA. lelting@mdanderson.org
Shih
Ya-Chen Tina
YC
D000553:Ambulatory Care / Q000191:economics; D003363:Cost Control; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D017050:Episode of Care; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D006278:Medicare / Q000191:economics; D009369:Neoplasms / Q000191:economics*; D005791:Patient Care / Q000191:economics*; D013781:Texas; D014481:United States