Understanding US Cancer Care Spending in 2018

• The 15 most prevalent cancers incurred a cost of $156.2 billion in 2018.
• Breast cancer patients contributed to the highest number of services and spending.
• Almost 20% of US cancer spending was on radiology

Although how to deliver quality but affordable care to US patients requiring cancer treatment has been widely debated, the specific expenses contributing to these figures are poorly understood. To address this, a Penn State Cancer Institute team analyzed the cost of providing cancer care in the US by the types of procedures performed and services provided. Among a sample supplied by MarketScan consisting of 27.1 million privately insured individuals under the age of 65, there were 38.4 million documented procedure codes for the 15 most prevalent cancers in 2018, totalling $10.8 billion. 402,115 patients incurred these costs. When extrapolated to the rest of the US population, the total cost of cancer care amounts to $156.2 billion in 2018.

When examined by category, medical supplies and nonphysician services (which include chemotherapy drugs) accounted for most of the cost. Across cancers, breast cancer contributed the highest number of services and total spending, mainly owing to high numbers of breast cancer survivors. 20% of these costs were associated with radiological services.

• Total US cancer care spending by percentage:

1. 37.0% is on medical supplies and nonphysician services (e.g., drugs).
2. 19.4% is on radiology.
3. 16.7% is on surgery.

• US cancer care spending by patient:

1. Pancreatic cancer (median, $32 806 [IQR, $10 866-$85 326])
2. Liver cancer (median, $30 156 [IQR, $9448-$80 520])
3. Esophageal cancer (median, $29 864 [IQR, $8677-$82 998])

• Total US cancer care spending by cancer type:

1. Breast cancer ($40.6 billion)
2. Prostate cancer ($19.4 billion)
3. Colorectal cancer ($19.2 billion)