Medical Resource Utilizations and Economic Burden in Chinese Cancer Patients with Chemotherapy-induced Anemia： A Populational Database Study

Medical resource utilizations and economic burden in Chinese cancer patients with chemotherapy-induced anemia: A populational database study

Objective  Most of published studies emphasized the medical cost of treating chemotherapy-induced anemia (CIA) by using specific agents, for example, epoetin α, epoetin β, darbepoetin α or combined with red blood cell transfusions, however, the investigation of the overall medical resources utilizations and economic burden of CIA is still limited. Besides, such studies which emphasized Chinese population still lack. The aim of this study is to investigate the medical resource utilization and the economic burden of Chinese cancer patients with CIA by using a populational representative claim database. Methods  The data for this study are from the 2000-2003 Population Health Insurance Research Database (PHIRD) in Taiwan. On the basis of issuing catastrophic illness cards in the enrollment data files, a total of 26,053 beneficiaries were identified from the PHIRD, who were newly diagnosed with these four cancers in 2001 and 2002 (2001: n=12,954; 2002: n=13099). A generalized linear model (GLM) was employed for analyzing the differences of medical resource utilization and economic burden between the anemic and non-anemic groups. Results  Analyses showed that the anemic patients were significantly more likely to have longer length of hospital stay than non-anemic patients (P<0.05) across all these four cancers and in two study periods (except women breast cancer in 2002/03). As regards the health care expenditures, the average one-year total medical cost was USD$8,982 (2001/02) and USD$8,990 (2002/03) for anemic patients among these four cancers, and USD$7,769 (2001/02) and USD$7713 (2002/03) for non-anemic patients (P<0.0001). As for ambulatory costs, anemic patients’ was significantly higher than non-anemic patients’ for lung cancer (in 2001/02), women breast cancer (in 2001/02 and 2002/03) and the summarized data (in 2001/02). As for inpatient costs, anemic patients’ was significantly higher than non-anemic patients’ for gastric cancer (in 2002/03), colon and rectal cancer (in 2001/02 and 2002/03), lung cancer (in 2001/02 and 2002/03), women breast cancer (in 2001/02) and the summarized data (in 2001/02 and 2002/03). Conclusion  This study is the first study to demonstrate that cancer patients who receive chemotherapy and with anemia utilize more medical resources and have heavier economic burden among Chinese cancer patients. Although the Population Health Insurance Program in Taiwan was established to provide more low-burdened medical care for all cancer patients, further effort is still needed to reduce the economic burden for cancer patients who have specific complications. This work was supported by a grant from Roche Co., Taiwan.