Cost of Cervical Cancer Treatment: Implications for Providing Coverage to Low-Income Women under the Medicaid Expansion for Cancer Care

• Published in: Women's health issues 2010-11, Vol.20 (6), p.400-405
• Main Authors: Subramanian, Sujha, PhD, Trogdon, Justin, PhD, Ekwueme, Donatus U., PhD, Gardner, James G., MPH, Whitmire, J. Timothy, PhD, Rao, Chandrika, PhD
• Format: Article
• Language: English
• Subjects: Adult; Breast Neoplasms - diagnosis; Breast Neoplasms - economics; Breast Neoplasms - therapy; Cancer; Care and treatment; Cervical cancer; Cervical Intraepithelial Neoplasia - diagnosis; Cervical Intraepithelial Neoplasia - economics; Cervical Intraepithelial Neoplasia - therapy; Cohort Studies; Cost effectiveness; Costs and Cost Analysis; Coverage; Diagnosis; Female; Health Care Costs - statistics & numerical data; Humans; Low income women; Medicaid; Medicaid - economics; Medicaid program; Medical service; Middle Aged; North Carolina; Obstetrics and Gynecology; Poor; Poverty; Registries; Regression Analysis; Time Factors; United States; Uterine Cervical Neoplasms - diagnosis; Uterine Cervical Neoplasms - economics; Uterine Cervical Neoplasms - therapy; Women; Young Adult
• ISSN: 1049-3867; 1878-4321
• DOI: 10.1016/j.whi.2010.07.002

Abstract Background To date, no study has reported on the cost of treating cervical cancer among Medicaid beneficiaries younger than 65 years of age. This information is essential for assessing the cost effectiveness of screening interventions for low-income women and the funding required for treatment programs established by the Breast and Cervical Cancer Prevention and Treatment Act of 2000. Methods Administrative data from the North Carolina Medicaid program linked with cancer registry data were used to analyze total Medicaid costs for these patients and the incremental costs of cervical cancer care at 6 and 12 months from diagnosis. We compared 207 beneficiaries diagnosed with cancer during the years 2002 to 2004 with 414 controls. Findings Total Medicaid costs at 6 months after diagnosis were $3,807, $23,187, $35,853, and $45,028 for in situ, local, regional, and distant cancers, respectively. The incremental cost of cancer treatment for local and regional cancers was $13,935 and $26,174 and by 12 months increased to $15,868 and $30,917, respectively. Conclusion Medicaid coverage may be required for many months after diagnosis to ensure the provision of comprehensive care, especially for women with late-stage cancers. Given the great differences in cost of early versus late-stage cancers, interventions aimed at increasing screening among low-income women are likely to be cost effective.