• Angela C Tramontano, Yufan Chen, Tina R Watson, Andrew Eckel, Deirdre F Sheehan, PetersMary Linton BMLBInstitute for Technology Assessment, Massachusetts General Hospital, Boston, MA.Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, MA.Harvard Medical School, Boston, MA., Pari V Pandharipande, Chin Hur, and Chung Yin Kong.
• Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA.
• Medicine (Baltimore). 2019 Dec 1; 98 (49): e18082.

ObjectivesOur study provides phase-specific cost estimates for pancreatic cancer based on stage and treatment. We compare treatment costs between the different phases and within the stage and treatment modality subgroups.MethodsOur cohort included 20,917 pancreatic cancer patients from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database diagnosed between 2000 and 2011. We allocated costs into four phases of care-staging (or surgery), initial, continuing, and terminal- and calculated the total, cancer-attributable, and patient-liability costs in 2018 US dollars. We fit linear regression models using log transformation to determine whether costs were predicted by age and calendar year.ResultsMonthly cost estimates were high during the staging and surgery phases, decreased over the initial and continuing phases, and increased during the three-month terminal phase. Overall, the linear regression models showed that cancer-attributable costs either remained stable or increased by year, and either were unaffected by age or decreased with older age; continuing phase costs for stage II patients increased with age.ConclusionsOur estimates demonstrate that pancreatic cancer costs can vary widely by stage and treatment received. These cost estimates can serve as an important baseline foundation to guide resource allocation for cancer care and research in the future.

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