Abstract
Abstract
Background
Patient medical out-of-pocket expenses are thought to be rising worldwide yet data describing trends over time is scant. We evaluated trends of out-of-pocket expenses for patients in Australia with one of five major cancers in the first-year after diagnosis.
Methods
Participants from the QSKIN Sun and Health prospective cohort Study with a histologically confirmed breast, colorectal, lung, melanoma, or prostate cancer diagnosed between 2011 and 2015 were included (n = 1965). Medicare claims data on out-of-pocket expenses were analysed using a two-part model adjusted for year of diagnosis, health insurance status, age and education level. Fisher price and quantity indexes were also calculated to assess prices and volumes separately.
Results
On average, patients with cancer diagnosed in 2015 spent 70% more out-of-pocket on direct medical expenses than those diagnosed in 2011. Out-of-pocket expenses increased significantly for patients with breast cancer (mean AU$2513 in 2011 to AU$6802 in 2015). Out-of-pocket expenses were higher overall for individuals with private health insurance. For prostate cancer, expenses increased for those without private health insurance over time (mean AU$1586 in 2011 to AU$4748 in 2014) and remained stable for those with private health insurance (AU$4397 in 2011 to AU$5623 in 2015). There were progressive increases in prices and quantities of medical services for patients with melanoma, breast and lung cancer. For all cancers, prices increased for medicines and doctor attendances but fluctuated for other medical services.
Conclusion
Out-of-pocket expenses for patients with cancer have increased substantially over time. Such increases were more pronounced for women with breast cancer and those without private health insurance. Increased out-of-pocket expenses arose from both higher prices and higher volumes of health services but differ by cancer type. Further efforts to monitor patient out-of-pocket costs and prevent health inequities are required.
Funder
National Health and Medical Research Council
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Genetics,Oncology
Reference37 articles.
1. Australian Institute of Health and Welfare (AIHW), Australasian Association of Cancer Registries (AACR). Cancer in Australia: in brief 2017. Cancer series no. 102. Cat. no. CAN 101. Canberra: AIHW; 2017.
2. Duckett S. Many Australians pay too much for health care - here's what the government needs to do. https://theconversation.com/many-australians-pay-too-much-for-health-care-heres-what-the-government-needs-to-do-61859?sa=pg1&sq=Duckett&sr=6. The Conversation. 2016;July 13.
3. Australian Institute of Health and Welfare (AIHW). Health expenditure Australia 2014–15 Cat No. HWE 67. Canberra: Australian Institute of Health and Welfare; 2016.
4. Karikios DJ, Schofield D, Salkeld G, Mann KP, Trotman J, Stockler MR. Rising cost of anticancer drugs in Australia. Intern Med J. 2014;44(5):458–63. https://doi.org/10.1111/imj.12399.
5. Gordon LG, Merollini KMD, Lowe A, Chan RJ. A systematic review of financial toxicity among Cancer survivors: we Can't pay the co-pay. Patient. 2017;10(3):295–309. https://doi.org/10.1007/s40271-016-0204-x.
Cited by
9 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献