Annual financial impact of well-differentiated thyroid cancer care in the United States.
BACKGROUND
Well-differentiated thyroid cancer (WDTC) is a prevalent disease, which is increasing in incidence faster than any other cancer. Substantial direct medical care costs are related to the diagnosis and treatment of newly diagnosed patients as well as the ongoing surveillance of patients who have a long life expectancy. Prior analyses of the aggregate health care costs attributable to WDTC in the United States have not been reported.


METHODS
A stacked cohort cost analysis was performed on the US population from 1985 to 2013 to estimate the number of WDTC survivors in 2013. Incidence rates, and cancer-specific and overall survival were based on Surveillance, Epidemiology, and End Results (SEER) data. Current and projected direct medical care costs attributable to the care of patients with WDTC were then estimated. Health care-related costs and event probabilities were based on Medicare reimbursement schedules and the literature.


RESULTS
Estimated overall societal cost of WDTC care in 2013 for all US patients diagnosed after 1985 is $1.6 billion. Diagnosis, surgery, and adjuvant therapy for newly diagnosed patients (41%) constitutes the greatest proportion of costs, followed by surveillance of survivors (37%), and nonoperative death costs attributable to thyroid cancer care (22%). Projected 2030 costs (in 2013 US dollars) based on current incidence trends exceed $3.5 billion.


CONCLUSIONS
Health care costs of WDTC are substantial. Unlike other cancers, the majority of the cost is incurred in the initial and continuing phases of care. With the projected increasing incidence, population, and survival trends, costs will continue to escalate.
Harvard Medical School, Boston, Massachusetts; Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts.
Carrie C
CC
Lubitz
Chung Y
CY
Kong
Pamela M
PM
McMahon
Gilbert H
GH
Daniels
Yufei
Y
Chen
Konstantinos P
KP
Economopoulos
G Scott
GS
Gazelle
Milton C
MC
Weinstein
D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D018426:SEER Program; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D014481:United States / Q000453:epidemiology
cost analysis; cost of cancer care; economic analysis; thyroid cancer