Table 1.
Model inputs-cancer costs per patient by cost type and cancer treatment phase.
| Cancer Treatment Care Phase | |||||
|---|---|---|---|---|---|
| Pre-Diagnosis (3 Months) |
Initial Care (12 Months) |
Continuing Care (Annual/12 Months) |
Terminal Care (12 Months) |
Total | |
| Direct Health System Costs | 1612 a | 28,891 a | 6070 a | 52,861 a | 89,434 |
| Direct Out-of-Pocket Costs | 0 | 10,649 b | 264 c | 2868 d | 13,781 |
| Direct Time Costs | 0 | 5774 e | 375 e | 3504 e | 9653 |
| Indirect Costs | 0 | 5923 f | 664 f | 5923 f | 12,510 |
| Total | 1612 | 51,237 | 7373 | 65,156 | 125,378 |
Cost estimates are presented as mean patient costs in 2021 CAD. Net costs were presented for direct health system costs, direct time costs, and indirect costs. Gross costs were presented for OOPCs. The pre-diagnosis phase is defined as the 3 months before cancer diagnosis and includes costs related to diagnostic testing and hospital admissions. The initial phase of care is defined as 12 months after diagnosis (including date of diagnosis) and includes the costs of primary course of therapy and any adjuvant therapy. The continuing care phase (expressed as an annual cost) encompasses costs with ongoing surveillance and active follow-up treatment for cancer recurrence and/or new primary cancers. The terminal phase of care is defined as the last 12 months before death (which may or may not be due to cancer) captures costs with the intensive services, often palliative in nature. Note, in the OncoSim model, not all individuals who die of cancer were in palliative care. a = These estimates are obtained from a study that includes phase-specific net costs for over 20 cancer sites. The mean net cost for all cancer sites is presented in the table for simplicity. This value includes direct costs incurred by the public third-party payer (i.e., health system) such as chemotherapy, radiation therapy, physician services, inpatient hospitalizations, etc. b = This estimate considers breast, colorectal, lung, and prostate cancer patients who have undergone a minimum of 4 weeks of cancer treatment. This estimate was used for the initial care phase and includes costs associated with drugs, homecare, supplies, travel, etc. c = This estimate considers long-term prostate cancer survivors. This value was used for the continuing care phase and includes costs of medication, equipment, homecare, etc. d = This estimate considers multiple cancer sites at the terminal stage of treatment (i.e., 12 months prior to death or the end of their participation in the study). This value includes personal expenses related to palliative care. e = This estimate is derived from a study from the US, which includes colorectal patients and estimates net time per treatment phase. The median Canadian hourly wage was used to determine net time costs. This value includes the cost of round-trip travel to care, waiting, and receiving care. f = This estimate considers multiple cancer sites for patients aged 25 to 61 years who survived at least 3 years after diagnosis. This estimate was used for the initial, continuing, and terminal care phases. It includes the net lost earnings from employment for patients.