Medicare 5-year cancer bill tops $21.1 bln: study

CHICAGO (Reuters) - Five years of cancer care for America's elderly cost Medicare $21.1 billion, a figure that will swell as the baby boomer generation ages, U.S. government researchers said on Tuesday.

Researchers at the National Cancer Institute said the cost of cancer care over five years varies widely by tumor type -- from less than $20,000 for an elderly patient with breast cancer or melanoma to more than $40,000 for a patient with lymphoma, brain or other nervous system cancers.

The figures, based on people diagnosed with cancer in 2004, suggest the highest costs occur within the first 12 months of care, when people are undergoing costly treatments, and in the last 12 months of life, when in-hospital costs spike.

The research by Robin Yabroff of the National Cancer Institute in Bethesda, Maryland, and colleagues, which appears in the Journal of the National Cancer Institute, is intended to offer policymakers a tool to prepare as the U.S. population expands and ages.

Joseph Lipscomb, a health policy researcher at Emory University in Atlanta, said the study is the first to combine cost estimates and survival data to arrive at long-term national estimates for 18 of the most common types of cancers in the elderly.

Medicare is the federal health insurance program for people 65 and older. The researchers based their estimates on 1999-2003 data from more than 700,000 cancer patients covered by Medicare and more than 1.6 million people covered by Medicare who did not have cancer.

These per-patient costs were applied to a five-year survival model and extrapolated to the U.S. Medicare population diagnosed with cancer in 2004.

Among the 18 cancer types studied, brain and nervous system cancers were by far the costliest for men in each phase of treatment over five years. In women, these cancers were the most expensive in the first year of diagnosis and the last year of life, but ovarian cancer was the most costly overall.

Cancers with the highest costs overall across women in the Medicare population were lung ($2 billion), colorectal ($1.6 billion) and breast ($1.4 billion). Among men they were prostate ($2.3 billion), lung ($2.2 billion) and colorectal ($1.5 billion).

The estimates reflect Medicare discounts and are reported in 2004 dollars.

"Few of these individual findings are startling; yet, taken together they provide the scientifically strongest picture yet of the incidence costs of cancer in aggregate and by tumor type for the elderly in the United States," Lipscomb wrote in a commentary.

The researchers did not include the cost of treating younger cancer patients, as they tend to receive more costly and aggressive therapies. As newer, more expensive treatments become more widely adopted, however, the cancer estimates for treating Medicare beneficiaries are likely to rise, they said.

There were about 10 million Americans living with cancer in 2003. The National Cancer Institute has estimated that, overall, the United States spent $72.1 billion in 2004 in direct costs for cancer care.

(Editing by Maggie Fox and John O'Callaghan)