VP, Biostatistics Ontada Chestnut Hill, United States
Background: In 2023, the American Cancer Society estimates that 106,970 new cases of colon cancer and 46,050 cases of rectal cancer will be diagnosed in the United States (US), making colorectal cancer (CRC) the third most common cancer. As such, it is important to understand the cost burden associated with CRC but there is limited literature on the cost of treating CRC in the community setting.
Objectives: We evaluated outpatient cost of care and changes in cost over time among patients with CRC from a large US network of community oncology clinics.
Methods: We included adult patients diagnosed with CRC in The US Oncology Network from January 1st, 2015 through December 31st, 2022 with available healthcare resource utilization data. Data were retrospectively sourced from the iKnowMed™ (iKM) oncology-specific electronic health record that captures outpatient practice encounter histories for nearly 40% of US community oncology practices. iKM records are deterministically linked to claims and remittance data. All costs were paid amount, standardized to 2022 US dollars ($), and analyzed descriptively as cost per patient per month (PPPM) longitudinally since 2015.
Results: This study included 20,731 eligible patients with CRC who were treated in all 4 US census divisions. The median (Q1, Q3) age was 63 (54, 72) years, 44% were female, 69% were White, and 7% were treated in rural areas. The distribution of payer type was 54% commercial, 45% Medicare/Medicaid, and 1% other. The median (Q1, Q3) total outpatient medical care costs were $1,665 ($538, $4,608) PPPM overall. While costs were stable from 2015-2019 (2015 median was $1,576; 2019 median was $1,528), they increased from $1,528 ($486, $4,587) in 2019 to $2,061 ($858, $4,472) in 2022. Higher costs were observed with more advanced stage of disease, ranging from $457 ($166, $1,656) among patients with stage I disease to $4,494 ($2,047, $8,016) among those with stage IV.
Conclusions: In this study of patients with CRC from community oncology clinics, we observed the highest costs of care in the most recent 3 years (compared to 2015-2019) and among patients with more advanced stage. These results may provide oncology providers, payers, and other stakeholders with insights into how changes in care influence costs, as well as the cost benefits of early identification and diagnosis of CRC.
