Cost analysis of pancreatic carcinoma treatment

BACKGROUND. Pancreatic carcinoma is a major health issue and financial burd en to society. To improve the quality and efficiency of care delivered, it is essential for health care providers to have a good understanding of the cost of treatment. METHODS. The authors examined the facility-based costs and survival of 103 patients with pancreatic carcinoma who were treated at the Karmanos Cancer Institute between January 1992 and September 1998. Longitudinal cost data f or each patient were obtained, and from those data, 6-month, I-year, and li fetime total treatment costs were calculated. RESULTS. The average 6-month, I-year, and lifetime total treatment costs we re $37,327, $42,218, and $48,803, respectively, and the median survival was 7 months. In univariate analyses, the disease stage at diagnosis was a hig hly significant predictor of total cost. Patients with metastatic disease h ad the lowest cost, and patients with resectable disease had the highest ca st. In multivariate analyses controlling for disease stage, treatment strat egies and dual insurance coverage were also important predictors of costs b ut patient age, race, and gender were not predictive. Disease stage also wa s highly predictive of survival. In a multivariate analysis controlling for disease stage, chemotherapy and radiation therapy were correlated with lon ger survival, whereas resection and palliative bypass surgery were not. CONCLUSIONS. The costs of treating patients with pancreatic carcinoma are c onsiderable, even though survival duration typically is short. Disease stag e was the most dominating factor determining costs and survival. After cont rolling for disease stage, chemotherapy, surgery, and dual insurance covera ge were also significantly associated with higher cost of care. However, in survival analyses, only chemotherapy and radiation therapy were associated with a significant increase in patient survival. (C) 2000 American Cancer Society.