Media contact: Beena Thannickal
Courtney WilliamsA new study from the O’Neal Comprehensive Cancer Center at UAB published in the Journal of the National Comprehensive Cancer Network found that direct costs for metastatic breast cancer patients increase dramatically when their treatment differs from recommendations in the NCCN Clinical Practice Guidelines in Oncology.
Previous studies have shown that guideline-discordant care results in higher health care costs overall. This study, led by Courtney Williams, a doctoral candidate in the UAB Department of Healthcare Organization and Policy and a statistician in the UAB Division of Hematology and Oncology, is the first to look at the cost burden specifically for patients.
Using a sample of 3,709 women with metastatic breast cancer from the SEER-Medicare database, she found about one in five women received a first-line anticancer treatment discordant within the NCCN guidelines.
“We found those receiving guideline discordant treatment had about $2,000 higher patient-specific costs, which are comprised of deductibles, coinsurance, copayments, in the year following their metastatic breast cancer diagnosis than those receiving an anticancer treatment listed within the NCCN guidelines,” said Williams. “This finding is especially important for older patients, which made up 75 percent of the sample, since financial and psychological distress could be worse for patients living on a fixed income.”
The median patient cost for the year post-diagnosis was $5,171 for care that fit within contemporary NCCN guidelines, versus $7,421 for care that deviated from them.
“NCCN guidelines exist to provide recommendations based on scientific evidence and expert opinion,” Williams said. “Although there will always be circumstances where off-guideline treatment is warranted, physicians should aim to comply with current guidelines for the safety of the patient, both physically and psychologically, as well as to decrease adverse outcomes such as financial toxicity.”