The costs of cancer to a major employer in the United States: A case-control analysis

Background Detailed data will be increasingly important in determining the cost of cancer care in the managed care setting, Objectives: To estimate the full cost of cancer to a major employer in the United States and to determine the nature of the expenditures, Study Design: Analysis of medical, pharmaceutical, and disability claims da ta from 1995 to 1997 for a major employer with more than 100,000 employees. Methods: The cost of cancer is determined on a per-patient and per-employee basis. Based on a case-control method, cancer patients are matched to indi viduals with no record of cancer diagnosis or treatment. The incremental co st per employee and the percentage of total healthcare expenditures for can cer are quantified, Results: Approximately $224 per active employee, or 6.5% of the corporation 's total healthcare costs, was spent on incremental care for cancer patient s in 1997, Medical conditions not directly related to cancer account for ap proximately half the total excess expenditures for patients with cancer. On average, annual healthcare and disability costs for persons with cancer we re approximately 5 times higher than for their counterparts without cancer. Conclusions: The costs of cancer care are a substantial proportion of healt hcare costs for employers. When the full cost of cancer is included in a co st-benefit analysis, expenditures for programs to reduce the risk of cancer in the working population may be justified. Expenditures to reduce the inc idence and severity of conditions indirectly associated with cancer may als o reduce overall employer healthcare expenses.