Rye Brook, NY (Oct. 29, 2018) – The costs to treat a blood cancer are higher than costs for other cancers, and the costs incurred by a patient diagnosed with a blood cancer do not return to pre-cancer levels, according to a Milliman study commissioned by The Leukemia & Lymphoma Society (LLS). Released today, this study—The Cost Burden of Blood Cancer Care—offers new information on the cost of blood cancer care that can inform payers, providers, patients, patient advocates and policymakers. Representatives from LLS and Milliman will present the findings of this study at the 2018 Association for Value-Based Cancer Care (AVBCC) Summit tomorrow.
More than 1.3 million people in the United States are either living with, or are in remission from, leukemia, lymphoma or myeloma. This study provides further evidence of the cost implications that a blood cancer diagnosis brings to the patient and the health system as a whole.
In May 2017, LLS launched the Cost of Cancer Care Initiative by putting forward more than two dozen potential policy solutions and other recommendations aimed at reducing the cost of care and improving transparency across the oncology ecosystem. These recommendations seek to protect and promote the interests of blood cancer patients by helping to address the unsustainable cost of care. This new study further informs this work, providing critical data about the cost of blood cancer care in commercial insurance plans to guide all stakeholders.
“We at LLS frequently hear from blood cancer patients about the rising costs associated with lifesaving treatment,” said Gwen L. Nichols, MD, LLS’s chief medical officer. “As this new study shows, each player in the healthcare system has a role to play in lowering these costs so patients can access their care. Armed with this data, LLS looks forward to continuing to work with stakeholders across the oncology ecosystem on solutions that put patients at the forefront in addressing the unsustainable cost of cancer care.”
Key findings from the study include:
Blood cancer care is very expensive for the healthcare system. While the cost magnitude for treating blood cancer varies widely by blood cancer type, these costs, on average, are higher than the costs associated with treating non-blood cancers, even those with expensive treatment protocols. Further, average monthly healthcare costs incurred by blood cancer patients do not return to pre-cancer spending levels, demonstrating a persistent cost burden to the system and the patient years after diagnosis.
Services that drive spending within the broader healthcare system differ from those that drive patient out-of-pocket costs. Across the full timeline of care, anti-cancer drug therapy is a key cost driver for the healthcare system. Patient out-of-pocket costs, however, are mostly driven by professional services, a category that includes inpatient hospital or outpatient hospital encounter as well as office-based and other care services. Professional services are also responsible for the highest portion of costs associated with out-of-network care, which are associated with higher out-of-pocket costs patients pay when they use services outside their insurance plan’s coverage network.
Very high spending occurs immediately following diagnosis. The month of diagnosis is the most expensive month for treating a blood cancer, primarily due to costs associated with inpatient hospitalizations.
Patient out-of-pocket costs are high and are impacted by insurance plan type and month of diagnosis. Patient out-of-pocket costs for blood cancer care average thousands of dollars per year and are strongly influenced by the patient’s insurance plan. Just as the costs to the healthcare system are the highest in the month of diagnosis, patient out-of-pocket costs are also the highest at the onset of treatment. Specific features of insurance plans also impact patient out-of-pocket costs. Patients enrolled in high deductible plans, for example, face on average almost twice as much in out-of-pocket costs as those enrolled in traditional plans. Out-of-pocket costs for blood cancer care spike during the month of diagnosis and then again at the beginning of each calendar year. This is due to the deductible and out-of-pocket limit that must be met each annual benefit cycle, which are typically calendar year cycles.
LLS received support for this work from Pfizer Inc, Genentech, Inc. and Amgen, Inc. A full version of the study can be viewed here.
About The Leukemia & Lymphoma Society
The Leukemia & Lymphoma Society® (LLS) is the world's largest voluntary health agency dedicated to fighting blood cancer. The LLS mission: Cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life of patients and their families. LLS funds lifesaving blood cancer research around the world, provides free information and support services, and is the voice for all blood cancer patients seeking access to quality, affordable, coordinated care.
Founded in 1949 and headquartered in Rye Brook, NY, LLS has chapters throughout the United States and Canada. To learn more, visit www.LLS.org. Patients should contact the Information Resource Center at (800) 955-4572, Monday through Friday, 9 a.m. to 9 p.m. ET.
Milliman is among the world's largest providers of actuarial and related products and services. The firm has consulting practices in healthcare, property & casualty insurance, life insurance and financial services, and employee benefits. Founded in 1947, Milliman is an independent firm with offices in major cities around the globe. For further information, visit www.milliman.com.
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