Cost of cervical cancer treatment: implications for providing coverage to low-income women under the Medicaid expansion for cancer care.
BACKGROUND
To date, no study has reported on the cost of treating cervical cancer among Medicaid beneficiaries younger than 65 years of age. This information is essential for assessing the cost effectiveness of screening interventions for low-income women and the funding required for treatment programs established by the Breast and Cervical Cancer Prevention and Treatment Act of 2000.


METHODS
Administrative data from the North Carolina Medicaid program linked with cancer registry data were used to analyze total Medicaid costs for these patients and the incremental costs of cervical cancer care at 6 and 12 months from diagnosis. We compared 207 beneficiaries diagnosed with cancer during the years 2002 to 2004 with 414 controls.


RESULTS
Total Medicaid costs at 6 months after diagnosis were $3,807, $23,187, $35,853, and $45,028 for in situ, local, regional, and distant cancers, respectively. The incremental cost of cancer treatment for local and regional cancers was $13,935 and $26,174 and by 12 months increased to $15,868 and $30,917, respectively.


CONCLUSIONS
Medicaid coverage may be required for many months after diagnosis to ensure the provision of comprehensive care, especially for women with late-stage cancers. Given the great differences in cost of early versus late-stage cancers, interventions aimed at increasing screening among low-income women are likely to be cost effective.
RTI International, Waltham, Massachusetts, 02451, USA. ssubramanian@rti.org
Sujha
S
Subramanian
Justin
J
Trogdon
Donatus U
DU
Ekwueme
James G
JG
Gardner
J Timothy
JT
Whitmire
Chandrika
C
Rao
D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008484:Medicaid / Q000191:economics*; D008875:Middle Aged; D009657:North Carolina; D011203:Poverty; D012042:Registries; D012044:Regression Analysis; D013997:Time Factors; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000191:economics* / Q000628:therapy