title: Cost differential by site of service for cancer patients receiving chemotherapy.
abstract: OBJECTIVE
  To compare the costs of: 1) chemotherapy treatment across clinical, demographic, and geographic variables; and 2) various cancer care-related cost categories between patients receiving chemotherapy in a community oncology versus a hospital outpatient setting.
  
  
  METHODS
  Data from the calendar years 2008 to 2010 from the Truven Health Analytics MarketScan Commercial Claims and Encounters Database were analyzed. During 2010, the data set contained approximately 45 million unique commercially insured patients with 70,984 cancer patients receiving chemotherapy. These patients were assigned to cohorts depending on whether they received chemotherapy at a community oncology or hospital outpatient setting.
  
  
  METHODS
  Cost data for 9 common cancer types were extracted from the database and analyzed on a per member per month basis to normalize costs; costs included amounts paid by the payer and patient payment. Community oncology and hospital outpatient setting chemotherapy treatment costs were categorized and examined according to cancer diagnosis, patient demographics, and geographic location.
  
  
  RESULTS
  Patients receiving chemotherapy treatment in the community oncology clinic had a 20% to 39% lower mean per member per month cost of care, depending on diagnosis, compared with those receiving chemotherapy in the hospital outpatient setting. This cost differential was consistent across cancer type, geographic location, patient age, and number of chemotherapy sessions. Various cost categories examined were also higher for those treated in the hospital outpatient setting.
  
  
  CONCLUSIONS
  The cost of care for patients receiving chemotherapy was consistently lower in the community oncology clinic compared with the hospital outpatient setting, controlling for the clinical, demographic, and geographic variables analyzed.
authors.affiliation: McKesson Specialty Health, 11000 Westmoor Cir, Ste 125, Westminister, CO 80021. E-mail: jad.hayes@mckesson.com.
authors.forename: Jad
authors.initials: J
authors.lastname: Hayes
authors.forename: Russell J
authors.initials: RJ
authors.lastname: Hoverman
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Brow
authors.forename: Dana C
authors.initials: DC
authors.lastname: Dilbeck
authors.forename: Diana K
authors.initials: DK
authors.lastname: Verrilli
authors.forename: Jody
authors.initials: J
authors.lastname: Garey
authors.forename: Janet L
authors.initials: JL
authors.lastname: Espirito
authors.forename: Jorge
authors.initials: J
authors.lastname: Cardona
authors.forename: Roy
authors.initials: R
authors.lastname: Beveridge
mesh_terms: D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D003151:Community Health Centers / Q000191:economics*; D003365:Costs and Cost Analysis; D016208:Databases, Factual; D006801:Humans; D009369:Neoplasms / Q000191:economics* / Q000628:therapy; D010044:Outpatient Clinics, Hospital / Q000191:economics*; D014481:United States
chemical_list: D000970:Antineoplastic Agents