Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-08T00:09:26.886Z Has data issue: false hasContentIssue false

24 - On the definition and measurement of the economic burden of cancer

Published online by Cambridge University Press:  18 December 2009

By
Mark C. Hornbrook Ph.D.
Edited by
Joseph Lipscomb ,
Carolyn C. Gotay  and
Claire Snyder
Mark C. Hornbrook Ph.D.
Affiliation:
Chief Scientist Center for Health Research Northwest/Hawai'i, Kaiser Permanente Northwest Region, Portland, OR
Joseph Lipscomb
Affiliation:
National Cancer Institute, Bethesda, Maryland
Carolyn C. Gotay
Affiliation:
Cancer Research Center, Hawaii
Claire Snyder
Affiliation:
National Cancer Institute, Bethesda, Maryland
Get access

Summary

Introduction

Economic analysis should play an essential role in controlling cancer, including defining priorities for research, treatment, screening, and prevention because society's resources are limited.– Competing demands for resources can give rise to decisions with myriad unforeseeable effects on costs, outcomes, and benefit distribution. Patients, families, physicians, and other providers face difficult trade-offs among alternative cancer prevention, screening, treatment, and palliation regimens with differing costs, probabilities of successful outcomes, side effects during treatment, and levels of uncertainties associated with estimates of these parameters. Even seeking additional information to reduce uncertainty about regimen options is costly, and the information gained will be of little value if it is wrong or irrelevant.

The concept of economic burden of disease is central to considerations of how to achieve an optimal resource allocation to and within health care.– Diseases that place the highest economic burdens on society, for example, should receive greater priority in medical and health services research compared to other diseases. Moreover, cancer treatments and prevention services that provide greater reductions in cancer's overall economic burden should receive greater priority in making coverage decisions, developing clinical practice guidelines, and making clinical decisions. Models that forecast cancer's economic burden are needed to understand the relative ranking among the sources of burden; to identify potential disease management opportunities so that appropriate practice guidelines can be developed, tested, and implemented; and to decompose total burden imposed by all comorbidities into cancer-related and cancer-unrelated.

Type
Chapter
Information
Outcomes Assessment in Cancer
Measures, Methods and Applications
 , pp. 480 - 502
Publisher: Cambridge University Press
Print publication year: 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hodgson, T. A., Meiners, M. R. (1982). Cost of illness methodology: a guide to current practices and proceduresMilbank Memorial Fund Quarterly/Health and Society 60(3):429–62CrossRefGoogle ScholarPubMed
Hodgson, T. A. (1983). The state of the art of cost-of-illness estimatesAdvances in Health Economics and Health Service Research 4:129–64Google ScholarPubMed
Rice, D. P., Hodgson, T. A., Kopstein, A. N. (1985). The economic costs of illness: a replication and updateHealth Care Financing Review 7(1):61–80Google ScholarPubMed
Hodgson, T. A. (1994). Costs of illness in cost-effectiveness analysis. A review of the methodologyPharmacoeconomics 6:536–52CrossRefGoogle ScholarPubMed
Gold, M. R., Siegel, J. E., Russell, L. B. et al. (1996). Cost-Effectiveness in Health and Medicine. New York: Oxford University Press
Drummond, M. F., O'Brien, B., Stoddart, G. L. et al. (1997). Methods for the Economic Evaluation of Health Care Programmes, (2nd Edition). Oxford: Oxford University Press
Rice, D. P., Hodgson, T. A. (1981). Social and economic implications of cancer in the United StatesVital and Health Statistics, Series 3 20:1–43Google Scholar
Brown, M. L. (1990). The national economic burden of cancer: an updateJournal of the National Cancer Institute 82(23):1811–14CrossRefGoogle ScholarPubMed
Evans, W. K., Will, B. P., Berthelot, J. M.et al. (1995). The cost of managing lung cancer in CanadaOncology (Huntington) 9(11 Suppl):147–53Google Scholar
Schuette, H. L., Tucker, T. C., Brown, M. L.et al. (1995). The costs of cancer care in the United States: implications for actionOncology (Huntington) 9(11 Suppl):19–22Google Scholar
Brown, M. L., Lipscomb, J., Snyder, C. (2001). The burden of illness of cancer: economic cost and quality of lifeAnnual Review of Public Health 22:91–113CrossRefGoogle ScholarPubMed
Koopmanschap, M. A., Roijen, L., Bonneux, L.et al. (1994). Current and future costs of cancerEuropean Journal of Cancer 30A(1):60–5CrossRefGoogle Scholar
Gross, C. P., Anderson, G. F., Powe, N. R. (1999). The relation between funding by the National Institutes of Health and the burden of diseaseNew England Journal of Medicine 17;340(24):1881–7CrossRefGoogle Scholar
Forbes, J. F. (1997). The incidence of breast cancer: the global burden, public health considerationsSeminars in Oncology 24(1 Suppl. 1):S20–35Google ScholarPubMed
Young, T. K., Kliewer, E., Blanchard, J.et al. (2000). Monitoring disease burden and preventive behavior with data linkage: cervical cancer among aboriginal people in Manitoba, CanadaAmerican Journal of Public Health 90(9):1466–8Google ScholarPubMed
Wunsch-Filho, V., Camargo, E. A. (2001). The burden of mouth cancer in Latin America and the Caribbean: epidemiologic issuesSeminars in Oncology 28(2):158–68CrossRefGoogle ScholarPubMed
Merrill, R. M., Weed, D. L. (2001). Measuring the public health burden of cancer in the United States through lifetime and age-conditional risk estimatesAnnals of Epidemiology 8:547–53CrossRefGoogle Scholar
Satcher, D. (2001). The unequal burden of cancerCancer 91(1 Suppl.):205–73.0.CO;2-K>CrossRefGoogle Scholar
Longman, A. J., Braden, C. J., Mishel, M. H. (1996). Side effects burden in women with breast cancerCancer Practice 4(5):274–80Google ScholarPubMed
Longman, A. J., Braden, C. J., Mishel, M. H. (1999). Side-effects burden, psychological adjustment, and life quality in women with breast cancer: pattern of association over timeOncology Nursing Forum 26(5):909–15Google ScholarPubMed
Mandelblatt, J. S., Bierman, A. S., Gold, K.et al. (2001). Constructs of burden of illness in older patients with breast cancer: a comparison of measurement methodsHealth Services Research 36(6 Pt 1):1085–107Google ScholarPubMed
Nijboer, C., Tempelaar, R., Sanderman, R.et al. (1998). Cancer and caregiving: the impact on the caregiver's healthPsycho-Oncology 7(1):3–133.0.CO;2-5>CrossRefGoogle ScholarPubMed
Munkres, A., Oberst, M. T., Hughes, S. H. (1992). Appraisal of illness, symptom distress, self-care burden, and mood states in patients receiving chemotherapy for initial and recurrent cancerOncology Nursing Forum 19(8):1201–9Google ScholarPubMed
Luce, B. R., Manning, W. G., Siegel, J. E. et al. (1996). Estimating costs in cost-effectiveness analysis. In Cost Effectiveness in Health and Medicine, ed. M. Gold, J. E. Siegel, L. B. Russell, M. C. Weinstein, pp. 176–213. New York: Cambridge University Press
Ubel, P. A. (2000). Pricing Life. Cambridge, MA: MIT Press
Ubel, P. A., Richardson, J., Menzel, P. (2000). Societal value, the person trade-off, and the dilemma of whose values to measure for cost-effectiveness analysisHealth Economics 9:127–363.0.CO;2-Y>CrossRefGoogle ScholarPubMed
National Heart, Lung, and Blood Institute. Fact Book for Fiscal Year 2002. Bethesda, MD, 2002. Available at: http://www.nhlbi.nih.gov/about/02factbk.pdf. Last accessed on September 12, 2004
Max, W., Rice, D. P., Sung, H. Y.et al. (2002). The economic burden of prostate cancer, California, 1998Cancer 94(11):2906–13CrossRefGoogle Scholar
Seifeldin, R., Hantsch, J. J. (1999). The economic burden associated with colon cancer in the United StatesClinicalTherapeutics 21(8):1370–9Google ScholarPubMed
Evans, W. K. (1998). Cost-effectiveness of vinorelbine alone or vinorelbine plus cisplatin for stage IV NSCLCOncology (Huntington) 12(3, Suppl. 4):18–25Google ScholarPubMed
Wirt, D. P., Giles, F. J., Oken, M. M.et al. (2001). Cost-effectiveness of interferon alfa-2b added to chemotherapy for high-tumor follicular non-Hodgkin's lymphomaLeukemia and Lymphoma 40(5–6):565–79CrossRefGoogle ScholarPubMed
Ramsey, S. D., Moinpour, C. M., Lovato, L. C.et al. (2002). Economic analysis of vinorelbine plus cisplatin versus paclitaxel plus carboplatin for advanced non-small-cell lung cancerJournal of the National Cancer Institute 94(4):291–7CrossRefGoogle ScholarPubMed
Du, W., Touchette, D., Vaitkevicius, V. K.et al. (2000). Cost analysis of pancreatic carcinoma treatmentCancer 89(9):1917–243.0.CO;2-L>CrossRefGoogle ScholarPubMed
Warren, J. L., Brown, M. L., Fay, M. P.et al. (2002). Costs of treatment for elderly women with early-stage breast cancer in fee-for-service settingsJournal of Clinical Oncology 20(1):307–16CrossRefGoogle ScholarPubMed
Brown, M. L., Riley, G. F., Potosky, A. L.et al. (1999). Obtaining long-term disease specific costs of care: application to Medicare enrollees diagnosed with rectal cancerMedical Care 37(12):1249–59CrossRefGoogle Scholar
Fireman, B. H., Quesenberry, C. P., Somkin, C. P.et al. (1997). Cost of care for cancer in a health maintenance organizationHealth Care Financing Review 18(4):51–76Google Scholar
Taplin, S. H., Barlow, W., Urban, N.et al. (1995). Stage, age, comorbidity, and direct costs of colon, prostate, and breast cancer care.Journal of the National Cancer Institute 87(6):417–26CrossRefGoogle ScholarPubMed
Hodgson, T. A., Cohen, A. J. (1999). Medical care expenditures for selected circulatory diseases: opportunities for reducing national health expendituresMedical Care 37 (11):994–1012CrossRefGoogle ScholarPubMed
Etzioni, R., Urban, N., Baker, M. (1996). Estimating the costs attributable to a disease with application to ovarian cancerJournal of Clinical Epidemiology 49:95–103CrossRefGoogle ScholarPubMed
Etzioni, R., Ramsey, S. D., Berry, K.et al. (2001). The impact of including medical care costs when estimating the costs attributable to a disease: a colorectal cancer case studyHealth Economics 10:245–56CrossRefGoogle ScholarPubMed
Hornbrook, M. C., Hurtado, A. V., Johnson, R. E. (1985). Health care episodes: definition, measurement and useMedical Care Review 42:163–218CrossRefGoogle Scholar
Hornbrook, M. C. (1995). Definition and measurement of episodes of care in clinical and economic studies. In Cost Analysis Methodology for Clinical Practice Guidelines Conference Proceedings, ed. M. L. Grady, K. A. Weis, AHCPR Publication No. 95–0001, pp. 15–40. Rockville, MD: US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research
Steinwachs, D. M. (1992). Episode of care framework: utility for medical effectiveness research. Medical Effectiveness Research Data Methods, M. Grady, ed. AHCPR Publication No. 92–0056. Rockville, MD: US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research
Rosen, A. K., Mayer-Oakes, A. (1998). Developing a tool for analyzing medical care utilization of adult asthma patients on indemnity and managed care plans: can an episode of care framework be used?American Journal of Medical Quality 13(4):203–12CrossRefGoogle Scholar
Rosen, A. K., Houchens, R. L., Gibson, T. B.et al. (1998). Developing episodes of care for adult asthma patients: a cautionary taleAmerican Journal of Medical Quality 13(1):25–35CrossRefGoogle ScholarPubMed
Rosen, A. K., Mayer-Oakes, A. (1999). Episodes of care: theoretical frameworks versus current operational realitiesJoint Commission Journal of Quality Improvement 25(3):111–28CrossRefGoogle ScholarPubMed
Ettner, S. L., Hermann, R., Tang, H. (1999). Differences between generalists and mental health specialists in the psychiatric treatment of Medicare beneficiariesHealth Services Research 34:737–60Google ScholarPubMed
Ward, M. M., Javitz, H. S., Smith, W. M.et al. (2000). A comparison of three approaches for attributing hospitalizations to specific diseases in cost analysesInternationalJournal of Technology Assessment in Health Care 16(1):125–36Google ScholarPubMed
Weed, L. J. (1968). Medical records that guide and teachNew England Journal of Medicine 278(11):593–600CrossRefGoogle ScholarPubMed
Weed, L. J. (1971). The problem oriented record as a basic tool in medical education, patient care and clinical researchAnnals of Clinical Research 3(3):131–4Google ScholarPubMed
Reinstein, L. (1977). Problem-oriented medical record: experience in 238 rehabilitation institutionsArchives of Physical Medicine and Rehabilitation 58(9):398–401Google ScholarPubMed
Fernow, L. A., Mackie, C., McColl, I.et al. (1978). The effect of problem-oriented medical records on clinical management controlled for patient risksMedical Care 16(6):476–87CrossRefGoogle ScholarPubMed
Lloyd, S. C. (1984). Computer-generated progress notes in an automated POMRJournal of Medical Systems 8(102):35–42CrossRefGoogle Scholar
Hornbrook, M. C., Goodman, M. J., Fishman, P. A.et al. (1998). Health-based payment and computerized patient record systemsEffective Clinical Practice 1(2):66–72Google ScholarPubMed
Hornbrook, M. C., Goodman, M. J., Fishman, P. A.et al. (1998). Building health plan databases to risk-adjust outcomes and paymentsInternational Journal for Quality in Health Care 10(6):531–8CrossRefGoogle ScholarPubMed
DiGianni, L. M., Garber, J. E., Winer, E. P. (2002). Complementary and alternative medicine use among women with breast cancerJournal of Clinical Oncology 20(18 Suppl.):34S–8SGoogle ScholarPubMed
Medical Economics Staff (2002). 200 Red Book. Montvale, NJ: Thomsen Medical Economics. Inc. See http://www.medec.com/html/products/productdetail/redbook.html, last accessed March 21, 2003
Physician Payment Review Commission (1990). Annual Report to Congress 1990. Washingon, DC: US Government Printing Office
Birenbaum, L. K., Clarke-Steffen, L. (1992). Terminal care costs in childhood cancerPediatric Nursing 18(3):285–8Google ScholarPubMed
Moore, K. (1998). Out-of-pocket expenditures of outpatients receiving chemotherapyOncology Nursing Forum 25(9):1615–20Google ScholarPubMed
Agency for Healthcare Research & Quality. Medical Expenditure Panel Survey. Available at http://www.ahrq.gov/data/mepsix.htm. Last accessed on September 12, 2004
Friedman, B., Mare, J., Andrews, R.et al. (2002). Practical options for estimating cost of hospital inpatient staysJournal of Health Care Finance 29:1–13Google ScholarPubMed
Hsiao, W. C., Braun, P., Dunn, D. L.et al. (1992). An overview of the development and refinement of the Resource-Based Relative Value Scale. The foundation for reform of U.S. physician paymentMedical Care 30(11 Suppl.):NS1–12CrossRefGoogle ScholarPubMed
Berlin, M. F., Faber, B. P., Berlin, L. M.et al. (1997). RVU costing applicationsHealthcare Financial Management 51(11):73–4, 76Google ScholarPubMed
Grimaldi, P. L. (2002). Medicare fees for physician services are resource-basedJournal of Health Care Finance 28(3):88–104Google ScholarPubMed
Bronstein, J. M., Adams, E. K. (2002).Rural-urban differences in health risks, resource use and expenditures within three state Medicaid programs: implications for Medicaid managed careJournal of Rural Health 18(1):38–48CrossRefGoogle ScholarPubMed
Fries, B. E., Schneider, D. P., Foley, W. J.et al. (1989). Case-mix classification of Medicare residents in skilled nursing facilities: resource utilization groups (RUG-T18)Medical Care 27(9):843–58CrossRefGoogle Scholar
Fries, B. E. (1990). Comparing case-mix systems for nursing home paymentHealth Care Financing Review 11(4):103–19Google ScholarPubMed
Fries, B. E., Schneider, D. P., Foley, W. J.et al. (1994). Refining a case-mix measure for nursing homes: resource utilization groups (RUG-III)Medical Care 32(7):668–85CrossRefGoogle Scholar
Carpenter, G. I., Main, A., Turner, G. F. (1995). Casemix for the elderly inpatient: resource utilization groups (RUGs) validation project. Casemix for the Elderly Inpatient Working GroupAge and Ageing 24(1):5–13CrossRefGoogle ScholarPubMed
Loeve, F., Brown, M. L., Boer, R.et al. (2000). Endoscopic colorectal cancer screening: a cost-saving analysisJournal of the National Cancer Institute 92(7):557–63CrossRefGoogle ScholarPubMed
Tsao, H., Rogers, G. S., Sober, A. J. (1998). An estimate of the annual direct cost of treating cutaneous melanomaJournal of the American Academy of Dermatology 38(5 Pt 1):669–80CrossRefGoogle ScholarPubMed
Grover, S. A., Coupal, L., Zowall, H.et al. (2000). The clinical burden of prostate cancer in Canada: forecasts from the Montreal Prostate Cancer ModelCanadian Medical Association Journal 162(7):977–83Google ScholarPubMed
O'Brien, this volume, Chapter 25
Fairclough, this volume, Chapter 17
Miller, L. L., Hornbrook, M. C., Archbold, P. G.et al. (1996). Development of use and cost measures in a nursing intervention for family caregivers and frail elderly patientsResearch in Nursing and Health 19(4):273–853.0.CO;2-F>CrossRefGoogle Scholar
Chochinov, H. M., Kristjanson, L. (1998). Dying to pay: the cost of end-of-life careJournal of Palliative Care 14(4):5–15Google ScholarPubMed
Emanuel, E. J., Fairclough, D. L., Slutsman, J.et al. (2000). Understanding economic and other burdens of terminal illness: the experience of patients and their caregiversAnnals of Internal Medicine 132(6):451–9CrossRefGoogle ScholarPubMed
Arno, P. S., Levine, C., Memmott, M. M. (1999). The economic value of informal caregivingHealth Affairs (Millwood) 18(2):182–8CrossRefGoogle ScholarPubMed
Hayman, J. A., Langa, K. M., Kabeto, M. U.et al. (2001). Estimating the cost of informal caregiving for elderly patients with cancerJournal of Clinical Oncology 19(13):3219–25CrossRefGoogle ScholarPubMed
Harrow, B. S., Tennstedt, S. L., McKinlay, J. B. (1995). How costly is it to care for disabled elders in a community setting?Gerontologist 35(6):803–13CrossRefGoogle Scholar
Goldman, D. P., Schoenbaum, M. L., Potosky, A. L.et al. (2001). Measuring the incremental cost of clinical cancer researchJournal of Clinical Oncology 19(1):105–10CrossRefGoogle ScholarPubMed
Hahn, R. W. (ed.). Risks, Costs, and Lives Saved: Getting Better Results from Regulation. New York: Oxford University Press
McGarity, T. O., Ruttenberg, R. (1997). Counting the cost of health, safety, and environmental regulationTexas Law Review 80:1997–2058Google Scholar
Harrington, W., Morgenstern, R. D. (2000). On the accuracy of regulatory cost estimatesJournal of Policy Analysis and Management 19:297–3183.0.CO;2-X>CrossRefGoogle Scholar
Morganstern, R. D., Pizer, W. A., Shih, J. S. (2001). The cost of environmental protectionThe Review of Economics and Statistics 83:732–8CrossRefGoogle Scholar
Joshi, S., Krishnan, R., Lave, L. (2001). Estimating the hidden costs of environmental regulationThe Accounting Review 76:171–98CrossRefGoogle Scholar
Freeman, A. M. (2002). Environmental policy since earth day I: what do we know about the benefits and costs?Agricultural and Resource Economics Review 31:1–14CrossRefGoogle Scholar
Feeny, this volume, Chapter 4
Murphy, K. M., Topel, R. H. (2003). The Economic Value of Medical Research. In Exceptional Returns: the Economic Value of America's Investment in Medical Research, ed. R. H. Topel, K. M. Murphy. Chicago, IL: University of Chicago PressCrossRef
Nord, E. (1999). Cost-value Analysis in Health Care. Cambridge: Cambridge University Press
Nord, E., Pinto, J. L., Richardson, J.et al. (1999). Incorporating societal concerns for fairness in numerical valuations of health programmesHealth Economics 8:25–393.0.CO;2-H>CrossRefGoogle ScholarPubMed
Harberger, A. C. (1978). On the use of distributional weights in social cost—benefit analysisJournal of Political Economy 86(2), Part 2, S87–S120CrossRefGoogle Scholar
Boardman, A. E., Greenberg, D. H., Vining, A. R. et al. (1996). Cost—Benefit Analysis: Concepts and Practice, pp. 37–47. Prentice Hall, Upper Saddle River, NJ

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×