Out-of-pocket costs can leave Medicare patients with the most common type of liver cancer in financial distress.
While Medicare payments in the first year after diagnosis with hepatocellular carcinoma (HCC) exceeded $65,000, out-of-pocket costs were more than $10,000, a new study found.
“As has been shown for other cancer types, we found patients with liver cancer suffer from high cancer-related financial burden,” said study co-author Dr. Amit Singal, a professor of internal medicine at University of Texas Southwestern in Dallas.
“Financial toxicity of cancer therapy can negatively impact patients, resulting in medical debt and even bankruptcy for some patients,” Singal said in a university news release.
The researchers said the cost of liver cancer treatment has been little studied.
Patients have had the benefit of several new treatments in the past decade, including new surgeries, radiation-based therapies and immunotherapies. While they can be effective, they are also difficult to afford.
Researchers used data from a Medicare database to examine first-year treatment costs for 4,525 patients ages 68 and older who were diagnosed with liver cancer between 2011 and 2015.
They then compared costs for patients with HCC with those for a matched set of patients with liver cirrhosis. (Medication claims were not included because they were not available for all patients.)
The researchers found that patients with liver cancer had significantly higher inpatient, outpatient and doctor costs compared with the cirrhosis-only patients. In the first year of treatment, median out-of-pocket costs were more than $7,000 higher than the costs for the cirrhosis patients, meaning half were higher.
Patients with early-stage liver cancer had lower costs.
Those with coexisting conditions, such as non-alcoholic fatty liver disease and fluid in the abdomen, had higher costs.
For most patients the cancer is diagnosed when it is beyond an early stage, researchers noted. Non-alcoholic fatty liver disease is an increasingly common underlying factor for liver cancer, they said.
“Our data highlight that HCC care not only causes considerable financial stress on the health care system but directly for patients and their family members, who suffer from high out-of-pocket costs,” Singal said. “There is a clear need for policy interventions and financial support systems in this patient population.”
By 2030, total cost of cancer treatment in the United States is expected to reach $250 billion.
Liver cancer deaths are also accelerating, partly due to detection in later stages. Liver cancer is expected to be the third-leading cause of cancer deaths by 2040, Singal said.
The study was published in Clinical Gastroenterology and Hepatology.
Mohammad A. Karim et al, Healthcare Costs for Medicare Patients With Hepatocellular Carcinoma in the United States, Clinical Gastroenterology and Hepatology (2022). DOI: 10.1016/j.cgh.2022.11.015
The US Centers for Disease Control and Prevention has more on liver cancer.
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