title: State-level cancer treatment costs: how much and who pays?
abstract: BACKGROUND
  Cancer treatment accounts for approximately 5% of national health expenditures. However, no state-level estimates of cancer treatment costs have been published.
  
  
  METHODS
  In analyses of data from the Medical Expenditure Panel Survey, the National Nursing Home Survey, the U.S. Census Bureau, the Current Population Survey, and the Centers for Medicare & Medicaid Services, this study used regression modeling to estimate annual state-level cancer care costs during 2004 to 2008 for 4 categories of payers: all payers, Medicare, Medicaid, and private insurance.
  
  
  RESULTS
  State-level cancer care costs ranged from $227 million to $13.6 billion (median = $2.0 billion) in 2010 dollars. Medicare paid between 25.1% and 36.1% of these costs (median = 32.5%); private insurance paid between 36.0% and 49.6% (median = 43.3%); and Medicaid paid between 2.0% and 8.8% (median = 4.8%). Cancer treatment accounted for 3.8% to 8.7% of all state-level medical expenditures (median = 7.0%), 8.5% to 15.0% of state-level Medicare expenditures (median = 10.6%), 1.0% to 4.9% of state-level Medicaid expenditures (median = 2.2%), and 5.5% to 10.9% of state-level private insurance expenditures (median = 8.7%).
  
  
  CONCLUSIONS
  The costs of cancer treatment were substantial in all states and accounted for a sizable fraction of medical expenditures for all payers. The high cost of cancer treatment underscores the importance of preventing and controlling cancer as one approach to manage state-level medical costs.
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3717, USA. ftangka@cdc.gov
authors.forename: Florence K
authors.initials: FK
authors.lastname: Tangka
authors.forename: Justin G
authors.initials: JG
authors.lastname: Trogdon
authors.forename: Donatus U
authors.initials: DU
authors.lastname: Ekwueme
authors.forename: Gery P
authors.initials: GP
authors.lastname: Guy
authors.forename: Isaac
authors.initials: I
authors.lastname: Nwaise
authors.forename: Diane
authors.initials: D
authors.lastname: Orenstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D008297:Male; D008484:Medicaid / Q000191:economics; D006278:Medicare / Q000191:economics; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics* / Q000628:therapy*; D012044:Regression Analysis; D014481:United States; D055815:Young Adult
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