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

      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.
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      Biography

      Sujha Subramanian, PhD, is a Senior Health Economist at RTI International and has extensive experience performing economic evaluation of cancer screening programs. She has also performed several assessments using economic modeling and undertaken policy analysis using a variety of secondary databases.

      Biography

      Justin Trogdon, PhD, is a Research Economist in the Public Health Economics Program at RTI International. His current research agenda includes program evaluation and cost-effectiveness studies, including the use of Web-based cost collection tools and methods for estimating the cost of diseases.

      Biography

      Donatus Ekwueme, PhD, is a Senior Health Economist with the Division of Cancer Prevention and Control, CDC. His research includes modeling the costs and cost-effectiveness of public health interventions, conducting economic analysis and evaluating the national cancer prevention and control programs.

      Biography

      Before his retirement this year, James Gardner, MPH, was a Public Health Analyst with CDC's Division of Cancer Prevention & Control. He developed and directed the performance-based funding process for the $180 million National Breast & Cervical Cancer Early Detection Program.

      Biography

      Timothy Whitmire, PhD, is a sociologist and has served with the State Center for Health Statistics for over 16 years. His research informs decisions about the health management of populations, cost-effectiveness of public health programs, and quality of care.

      Biography

      Chandrika Rao, PhD, is the Interim Director of the North Carolina Central Cancer Registry. She manages registry operations, supervises annual data submissions, oversees data analysis and linkages, and collaborates with researchers and public health agencies.