OBJECTIVE: Ovarian cancer (OC) is the fourth most common cancer among women, with approximately 21,650 new cases diagnosed in the United States in 2008. Limited data exist on the economic burden associated with OC.
METHODS: This retrospective matched cohort database analysis examined the costs associated with OC in a managed care population. Patients were selected for inclusion in the OC cohort if they were diagnosed with OC (ICD-9-CM codes 183.0x and 183.2x) between January 1, 2002 and December 31, 2007. The date of the first OC diagnosis was termed the index date, and patients were required to have continuous enrollment for at least 6 months pre-and 12 months post-index. Patients in the OC cohort were matched approximately 1:5 to patients without OC based on age (±5 years), geographic region, plan and payer type, and pre-index comorbidities. Study measures included patient demographics and all-cause health care utilization and costs by component (i.e., inpatient, skilled nursing facility, emergency department, office visits, pharmacy, other services, and total). Cost and utilization measures were aggregated over the 12- month post-index period. Costs were adjusted to 2008 dollars. Statistical significance between OC cases and controls was defined as Pb 0.05 based on Student's t test.
RESULTS: Fourteen thousand three hundred forty-four patients with OC met the selection criteria and could be matched to a control. Among patients with OC, mean (SD) age was 54.28 (14.66) years, two-thirds were covered by an HMO or PPO, and the mean (SD) Charlson score was 1.40 (2.48). The total health care costs for patients with OC were more than eight times larger than costs for matched controls (mean [SD], $31,918 [$53,420] vs $3657 [$13,982], Pb 0.001). Among patients with OC, the key drivers of total costs included inpatient, pharmacy, and other outpatient services (representing 29, 26, and 40% of total health care costs).
CONCLUSIONS: The economic burden of OC is substantial. We estimate that the incremental cost of OC to managed care payers compared with controls is $28,261 per patient per year. Based on an estimated incidence of 21,650 cases, we estimate the annual cost to the U.S. health care system of managing patients with OC is approximately $612 million.
