Out-of-pocket cost by cancer stage at diagnosis in commercially insured patients in the United States

Figures & data

Table 1. Out-of-pocket cost in commercially insured patients by cancer type and stage, year 1 post-diagnosis.

Stage	I	II	III	IV
Breast Cancer	N = 3,686
n	1,771	1,289	329	297
OOP Cost, mean (SD)	$8,979 ($8,809)	$10,270 ($9,938)	$10,421 ($12,130)	$11,348 ($9,895)
OOP Cost, median (range)	$1,204 ($0–$450,374)	$1,295 ($–$431,085)	$1,259 ($0–$375,082)	$1,769 ($0–$292,270)
Cervical Cancer	N = 714
n	485	78	82	68
OOP Cost, mean (SD)	$6,981 ($5,908)	$8,495 ($7,032)	$12,344 ($11,552)	$10,001 ($10,534)
OOP Cost, median (range)	$1,188 ($0–$172,102)	$1,849 ($0–$96,753)	$1,617 ($0–$173,255)	$1,406 ($0–$135,444)
Colorectal Cancer	N = 1,010
n	105	219	387	299
OOP Cost, mean (SD)	$9,266 ($7,544)	$8,046 ($11,138)	$8,742 ($8,471)	$10,479 ($8,985)
OOP Cost, median (range)	$1,803 ($0–$139,104)	$1,277 ($0–$232,267)	$1,535 ($0–$230,331)	$2,020 ($0–$246,246)
Lung Cancer	N = 1,010
n	170	127	169	544
OOP Cost, mean (SD)	$8,305 ($7,439)	$11,371 ($11,872)	$12,474 ($10,396)	$14,611 ($13,372)
OOP Cost, median (range)	$1,342 ($0–$156,739)	$1,167 ($0–$247,965)	$2,116 ($0–$240,354)	$2,563 ($0–$398,354)
Ovarian Cancer	N = 322
n	118	39	107	58
OOP Cost, mean (SD)	$6,639 ($6,906)	$8,753 ($8,344)	$9,516 ($9,952)	$9,912 ($7,438)
OOP Cost, median (range)	$980 ($0–120,369)	$2,728 ($0–$82,403)	$1,354 ($0–203,469)	$1,771 ($0–$89,284)
Prostate Cancer	N = 753
n	216	291	86	160
OOP Cost, mean (SD)	$6,640 ($5,885)	$8,051 ($7,277)	$9,161 ($6,934)	$8,222 ($8,344)
OOP Cost, median (range)	$1,436 ($0–169,276)	$1,203 ($0–$180,560)	$1,105 ($11–$122,574)	$1,494 ($0–$187,811)

Abbreviations. OOP, out-of-pocket; SD, standard deviation.

OOP costs include the coinsurance, copay, and deductible.

Table 2. Out-of-pocket cost in commercially insured patients by cancer type and stage, year 2 post-diagnosis.

Stage	I	II	III	IV
Breast Cancer	N = 2,059
n	1,039	739	180	101
OOP Cost, mean (SD)	$5,966 ($5,494)	$6,207 ($5,546)	$8,649 ($8,909)	$7,371 ($6,491)
OOP Cost, median (range)	$1,109 ($0–$247,055)	$951 ($0–$208,324)	$919 ($0–$237,256)	$581 ($0–$125,202)
Cervical Cancer*	N = 355
n	258	39	38	20
OOP Cost, mean (SD)	$6,354 ($6,397)	$6,329 ($5,876)	$7,659 ($8,405)	$5,532 ($6,512)
OOP Cost, median (range)	$1,079 ($0–$173,133)	$1,483 ($19–$66,168)	$861 ($0–$88,806)	$595 ($14–$46,651)
Colorectal Cancer	N = 435
n	51	101	191	92
OOP Cost, mean (SD)	$6,795 ($4,981)	$4,941 ($4,070)	$5,848 ($4,435)	$9,675 ($8,895)
OOP Cost, median (range)	$1,575 ($22–$60,321)	$904 ($0–$71,907)	$932 ($0–$104,556)	$682 ($0–$142,368)
Lung Cancer	N = 335
n	77	52	60	146
OOP Cost, mean (SD)	$7,407 ($5,944)	$11,164 ($12,800)	$10,156 ($11,656)	$11,394 ($11,674)
OOP Cost, median (range)	$1,541 ($0–$98,027)	$1,267 ($0–$177,154)	$1,012 ($0–$168,781)	$527 ($0–$263,468)
Ovarian Cancer	N = 150
n	55	24	49	22
OOP Cost, mean (SD)	$5,944 ($5,300)	$5,948 ($3,944)	$5,889 ($6,218)	$6,171 ($5,484)
OOP Cost, median (range)	$1,246 ($0–$79,210)	$1,761 ($0–$37,062)	$561 ($0–$77,234)	$880 ($0–$52,393)
Prostate Cancer	N = 377
n	125	151	36	65
OOP Cost, mean (SD)	$4,732 ($3,663)	$5,568 ($7,574)	$7,266 ($6,098)	$5,549 ($5,534)
OOP Cost, median (range)	$1,241 ($0–$77,816)	$826 ($0–$167,444)	$1,460 ($7–$73,818)	$384 ($0–$86,077)

Abbreviations. OOP, out-of-pocket; SD, standard deviation.

OOP costs include the coinsurance, copay, and deductible; * One outlier patient with mean out-of-pocket costs of > $2 million removed from year 2 calculations of stage I.

Table 3. Out-of-pocket cost in commercially insured patients by cancer type and stage, year 3 post-diagnosis.

Stage	I	II	III	IV
Breast Cancer	N = 1,138
n	575	433	93	37
OOP Cost, mean (SD)	45,500 ($4,773)	$7,178 ($6,036)	$6,502 ($5,877)	$10,487 ($10,064)
OOP Cost, median (range)	$1,212 ($0–$184,343)	$1,101 ($0–$178,934)	$1,049 ($0–$105,290)	$540 ($0–$116,429)
Cervical Cancer	N = 184
n	145	18	14	7
OOP Cost, mean (SD)	$5,863 ($5,015)	$3,185 ($1,485)	$4,469 ($6,132)	$6,823 ($8,237)
OOP Cost, median (range)	$1,180 ($0–$121,316)	$1,790 ($101–$12,018)	$923 ($20–$33,810)	$1,057 ($78–$21,611)
Colorectal Cancer	N = 207
n	28	48	101	30
OOP Cost, mean (SD)	$8,407 ($7,668)	$9,956 ($23,867)	$6,140 ($5,008)	$7,742 ($5,398)
OOP Cost, median (range)	$1,709 ($0–$69,808)	$1,055 ($0–$184,477)	$870 ($0–$87,309)	$998 ($0–$54,760)
Lung Cancer	N = 137
n	41	19	28	49
OOP Cost, mean (SD)	$5,018 ($4,270)	$6,918 ($4,078)	$10,495 ($8,263)	$9,248 ($8,809)
OOP Cost, median (range)	$1,148 ($0–$47,224)	$1,145 ($0–$41,415)	$1,589 ($0–$85,458)	$578 ($0–$119,262)
Ovarian Cancer	N = 73
n	34	13	19	7
OOP Cost, mean (SD)	$7,451 ($6,603)	$5,036 ($2,880)	$4,155 ($2,925)	$6,914 ($6,524)
OOP Cost, median (range)	$1,640 ($11–$49,757)	$2,515 ($11–$18,105)	$776 ($0–$29,095)	$3,883 ($3–$21,489)
Prostate Cancer	N = 188
n	72	74	19	23
OOP Cost, mean (SD)	$5,301 ($4,708)	$5,135 ($5,262)	$5,613 ($4,019)	$7,476 ($6,155)
OOP Cost, median (range)	$1,198 ($0–$77,324)	$916 ($0–$79,155)	$1,598 ($16–$35,943)	$385 ($0–$54,855)

Abbreviations. OOP, out-of-pocket; SD, standard deviation.

OOP costs include the coinsurance, copay, and deductible.

Figure 1. Cumulative out-of-pocket cost by stage at diagnosis. (a) Breast cancer; (b) Cervical cancer; (c) Colorectal cancer; (d) Lung cancer; (e) Ovarian cancer; and (f) Prostate cancer.

Figure 2. Out-of-pocket cost by stage at diagnosis, years 1–3 post-diagnosis. (a) Breast cancer; (b) Cervical cancer; (c) Colorectal cancer; (d) Lung cancer; (e) Ovarian cancer; and (f) Prostate cancer.