Cancer Health Economics and Cost of Care

• The cost of cancer care has risen substantially over the last 20 years.
• Cancer-related care employs a varied and complex array of providers and multimodal screening, diagnostic technologies, cancer treatments and supportive care therapies.
• Faced with complex alternatives and limited evidence regarding effectiveness, financial incentives may become predominant factors in choice of provider, care setting and treatment.
• The rising cost of cancer care coincides with expansions of publicly subsidized insurance, leading to a greater proportion of cancer care paid for by public funds.
• Due to changes in private health insurance benefits, commercial insurers may increase shifting of healthcare costs to patients through higher co-pays and deductibles.
• A growing number of cancer patients have difficulty paying their medical bills and experience a range of economic consequences, collectively referred to as financial hardship. The growing financial burden associated with cancer care may further exacerbate existing health care disparities.

Cost of cancer-related medical care

• Economic factors affecting the delivery of cancer prevention and screening services.
• Healthcare utilization and cost trajectories, both during and beyond initial therapy.
• Variation in healthcare utilization and cost by patient sociodemographic, health status, social need, cancer type and other characteristics.
• Impact of patient insurance status, type of insurance, specific coverage policies and financial incentives, on utilization and cost of cancer-related care.
• Time and travel costs for patients and caregivers and the impact of these costs on healthcare utilization and other patient outcomes.
• Cost and cost-effectiveness of cancer prevention, treatment, and survivorship care interventions.

Cancer-related financial hardship

• Impact of financial hardship on patient outcomes and health care access and utilization.
• Variation in out-of-pocket costs and their influence on patient’s utilization of cancer screening, treatment or survivorship care.
• Delivery of financial navigation services and the impact on patient outcomes.
• Cost communication during treatment and survivorship care.
• Coping strategies that patients use to manage the high out-of-pocket costs for medical care and how these strategies affect clinical outcomes.
• Patient, provider, healthcare system, and community-level interventions that mitigate the impact of financial hardship on patient outcomes and enhance health equity.

Employment outcomes among cancer survivors

• How patients’ sociodemographic characteristics, behaviors, cancer type, treatment, and toxicities affect cancer-related work outcomes.
• Modifiable risk factors for employment disruption after cancer.
• Identification and integration of interventions to mitigate the impact of cancer and its treatment on employment outcomes.

Organizational and provider characteristics

• How financial incentives, regulations, and market structure influence cancer care providers and organizational structure of the healthcare system.
• Effects of financial incentives and other policies directed at providers that may influence quality, quantity, and cost of cancer-related care.
• Economic factors influencing the de-implementation of low-value care.

To support research in these areas, the NCI develops and makes available various data resources, and offers research funding, and engages in collaborations with other federal agencies, outside non-profit foundations, and other stakeholder groups.