What are recent trends in cancer spending and outcomes? - PowerPoint Presentation

Slide1

What are recent trends in cancer spending and outcomes?

Source

:

Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health status: Health status indicators", OECD Health Statistics (database). doi: 10.1787/data-00540-en (Accessed on January 22, 2016).  Note: Comparable countries are defined as those with above median GDP and above median GDP per capita in at least one of the past ten years.

Unlike the other leading causes of death, cancer mortality rates are lower in the U.S. than in comparable countries

Age-adjusted major causes of mortality

per 100,000

population, in years, 2010

Source

:

Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health status: Health status indicators", OECD Health Statistics (database). doi: 10.1787/data-00540-en (Accessed on January 22, 2016).  Note: Comparable countries are defined as those with above median GDP and above median GDP per capita in at least one of the past ten years.

Compared to similar countries, the U.S. has a relatively low mortality rate for cancers

Age-adjusted neoplasm mortality rate

per 100,000

population, in years, 2010

Source

: Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health status: Health status indicators", OECD Health Statistics (database). doi

: 10.1787/data-00540-en (Accessed on January 22, 2016).  Notes: Comparable countries are defined as those with above median GDP and above median GDP per capita in at least one of the past ten years. Break in series in 1987 and 1997 for Switzerland; in 1995 for Switzerland; in 1996 for Netherlands; in 1998 for Australia, Belgium, and Germany; in 1999 for United States; in 2000 for Canada and France; and in 2001 in the United Kingdom. All breaks in series coincide with changes in ICD coding.

The mortality rate for cancers has been falling in the U.S. and across comparable countries

Age-adjusted neoplasms mortality rate

per 100,000

population

Comparable country average

United States

Source:

Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health status: Health status indicators", OECD Health Statistics (database).

doi: 10.1787/data-00540-en (Accessed on January 22, 2016).  Notes: Comparable countries are defined as those with above median GDP and above median GDP per capita in at least

one of the past ten

years. Data for breast and cervical cancers are for females.

Mortality rates

for

breast and colorectal cancer

in the U.S.

are lower than in comparable

countries

Age-standardized mortality rate per 100,000 population for breast, colorectal, and cervical cancer, in years, (2010)

Source

:

Surveillance, Epidemiology, and End Results Program (SEER) http://seer.cancer.gov/csr/1975_2012/browse_csr.php?sectionSEL=5&pageSEL=sect_05_table.08.html (Accessed on January 23, 2016). Notes:

SEER 9 areas (San Francisco, Connecticut, Detroit, Hawaii, Iowa, New Mexico, Seattle, Utah, Atlanta). Based on follow-up of patients into 2012.

Five-year survival for breast and colorectal cancers are increasing

Percentage of age-adjusted five-year relative survival for breast, colorectal, and cervical cancer, all ages, in years 1990-1992 and 2005-2011

Source

:

Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health status: Health status indicators", OECD Health Statistics (database). doi: 10.1787/data-00592-en (Accessed on January 22, 2016).  Notes:

Comparable countries are defined as those with above median GDP and above median GDP per capita in at least one of the past ten

years.

Data

for breast and cervical cancers are for females.

Five-year survival rates for certain cancers are slightly higher in the U.S. than in comparable countries

Percentage of age-adjusted five-year relative survival for breast, colorectal, and cervical cancer, ages 15-99, in years 2006-2011

Source

: Institute for Health Metrics and Evaluation. Global Burden of Disease Study

Data Downloads, available here: http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads (Accessed May 11, 2016)Cancer and circulatory diseases are the leading causes of premature death in the U.S.

Age standardized years of life lost (YLL) rate per 100,000 population, both sexes, 2013

Source

: Institute for Health Metrics and Evaluation. Global Burden of Disease Study Data Downloads, available here:

http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads (Accessed May 11, 2016)Cancer is among the top three leading causes of disease burden in the U.S.Age standardized disability adjusted life years (DALYs) rate per 100,000 population, both sexes, 2013

Source

: Institute for Health Metrics and Evaluation. Global Burden of Disease Study Data Downloads, available here:

http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads (Accessed May 11, 2016)U.S. disease burden has decreased in past two decades for circulatory, cancer, injuries, and neonatal disorders

Age standardized disability adjusted life years (DALYs) rate per 100,000 population, both sexes, 1990 and 2013

Source

: Institute for Health Metrics and Evaluation. Global Burden of Disease Study Data Downloads, available here:

http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads (Accessed May 11, 2016)Disease burden due to cancer is most caused by lung cancer; for both males and females

MALES

Age standardized disability adjusted life years (DALYs) rate per 100,000 population, males in the U.S., 2013

FEMALES

Age standardized disability adjusted life years (DALYs) rate per 100,000 population, females in the U.S., 2013

Source

: Commission on Cancer, American College of Surgeons and American Cancer Society, National Cancer Data Base

More women are receiving biopsy at the time of mastectomy or lumpectomyPercentage of women with clinical Stage I-IIb

breast cancer who received axillary node dissection or sentinel lymph node biopsy

(

SLNB) at

the time of surgery (lumpectomy or mastectomy

),

United States, 2004-2011

Source

: Kaiser Family Foundation analysis of 2013

OECD data: "OECD Health Data: Health status: Health status indicators", OECD Health Statistics (database). doi: 10.1787/data-00349-en (Accessed on January 22, 2016). Notes

: Break in series in 1999 for United States. Break

in series

coincides

with changes in ICD coding.

Recent decline in U.S. mortality rates largely reflects improvement for circulatory diseases

Overall age-adjusted mortality rate per 100,000 population

Source:

Bureau of Economic Analysis Health Care Satellite Account (Blended Account) and National Health Expenditure Data

Note: Spending on dental services, nursing homes, and prescriptions that cannot be allocated to a specific disease not included above. Data last updated January 25, 2016.Cancer spending accounts for about

7% of disease based health expenditures

Total expenditures in US $ billions by disease category, 2012

Source

:

Kaiser Family Foundation analysis of Bureau of Economic Analysis Health Care Satellite Account (Blended Account)Note: Expenditures on nursing home and dental care are not included in health services spending by disease. Data last updated January 25, 2016.

On a per capita basis, the U.S. spends about $394 per year to treat cancer, up from $219 in 2000

Per capita expenditures on the treatment of cancers and tumors (neoplasms), US $, 2000 - 2012

Source

: Kaiser Family Foundation analysis of Bureau of Economic Analysis Health Care Satellite Account (Blended Account)

Note: Expenditures on nursing home and dental care are not included in health services spending by disease. Data last updated January 25, 2016.While Cancer is one of the top contributors to disease burden, it is not a leading driver of medical services spending growth from 2000-2012

Contribution to medical services expenditure growth, by disease, 2000-2012

Source

: Kaiser Family Foundation analysis of Bureau of Economic Analysis Health Care Satellite Account (Blended Account)

Note: Expenditures on nursing home and dental care are not included in health services spending by disease. Data last updated January 25, 2016.Average growth in per capita spending for cancer was slightly lower than the average for all disease categoriesAverage annual growth in expenditures by disease category (per capita), price index by disease category (cost to treat each case), and real expenditures by disease category (number of treated cases), 2000 - 2012

Source:

Kaiser Family Foundation analysis of Medical Expenditure Panel Survey, Agency for Healthcare Research and Quality, U.S. Department of Health and Human

Services Note: For all diagnoses shown, with the exception of asthma, diagnosis status was asked only of respondents age 18 or older. All respondents were asked about their asthma diagnosis status.Diagnosis with a serious or chronic health condition is associated with higher spending

Per

capita health spending based on diagnosis status, in $U.S. Dollars, 2013

People with a diagnosis of a serious

or chronic health condition face higher average out-of-pocket costs

Source:

Kaiser Family Foundation analysis of Medical

Expenditure Panel Survey, Agency for Healthcare Research and Quality, U.S. Department of Health and Human

Services

Average out-of-pocket spending

per

person based on diagnosis status, in U.S. Dollars, 2013

Source

: Express Scripts 2014 Drug

Trend ReportCancer medications were among the top 3 conditions for specialty drug spending in 2014Express Scripts per-member-per-year

spending,

top 10 specialty

therapy

class drugs,

2014

Source

: World Lung Foundation and The American Cancer Society. The Tobacco Atlas. Available at:

http://www.tobaccoatlas.org/topic/cigarette-use-globally/ (Accessed on January 5, 2016).Per capita cigarette consumption is lower in the United States than in comparably wealthy countries

Number of cigarettes smoked per capita per year, age 15+, 2014

Source

: Kaiser Family Foundation analysis of data from the University of Washington Institute for Health Metrics and Evaluation. Available at:

http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads (Accessed on November 23, 2015).The U.S. has higher than average disease burden from lung cancerLung, tracheal, and bronchus cancer age-standardized

disability

adjusted life years (DALY) rate per 100,000 population

, 2013