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.
Article info
Publication history
Accepted:
July 14,
2010
Received in revised form:
June 21,
2010
Received:
March 25,
2010
Footnotes
Funded in part by Contract No. 200-2002-00575 TO 06 from the Centers for Disease Control and Prevention (CDC). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.
Identification
Copyright
© 2010 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
