• Private U.S. insurance companies spent an estimated $15.1 billion on services for adults with lung cancer in 2018, according to a new survey.
• Most of the total costs for lung cancer covered medical supplies and nonphysician services, which include injections of dexamethasone and ondansetron.
• Researchers hope that examining spending on services and procedures will help providers identify more cost-effective approaches.

Breast, lung, and colorectal cancers are among the costliest cancers currently affecting Americans under 65 with private insurance, according to a new survey. These costs can come from medical supplies, surgeries, and pharmaceutical drugs.

In the case of lung cancer diagnosis, treatment, and care, private insurance companies paid approximately $15.1 billion dollars in 2018 in the U.S. for adults under 65. The high cost of diagnostic tests, physician and hospital bills, and pharmacy bills make up a large portion of the direct costs of lung cancer treatment, as found by a 2007 study referenced in the new survey.

In the new survey, researchers at The Pennsylvania State University (Penn State) looked at a variety of cancers, and found that in 2018, the cost of care for the 15 most prevalent types of cancer (including lung cancer) was approximately $156.2 billion for privately insured Americans under 65 years old.

“The purpose of the current work is to characterize the most frequent medical services provided for privately insured cancer patients in the US and the costs associated with these services,” wrote the authors of the study. “The results of this work may be used to identify patients and services that most contribute to spending, with the ultimate goal of identifying potential targets for decreasing resource consumption.”

Cancer Costs, by the Numbers

The report analyzed members of the MarketScan database, which is a record of administrative medical claims including individual medical reports, clinical records, and prescription records. Dr. Nicholas Zaorsky and his team looked at a sample pool of 27.1 million privately insured people. Among them, 402,115 had been diagnosed with one of the 15 most prevalent types of cancer, including lung cancer.

The five most prevalent forms of cancer among the 402,115 people in the database were:

• Breast cancer — 124,543 cases
• Prostate cancer — 56,775 cases
• Thyroid cancer — 40,974 cases
• Lymphoma — 31,760 cases
• Colorectal cancer — 30,942 cases

Lung cancer was the seventh most prevalent with 16,882 cases.

According to the National Cancer Institute, breast cancer is the most common type of cancer in the United States with more than 284,000 new cases estimated in 2021. Prostate cancer is the second most prevalent (248,530 new cases in 2021), followed by lung cancer (235,760).

All together, the Penn State survey found that insurance companies had spent a total of $10.8 billion on cancer treatments in 2018 among the pool of 402,115 adults. People with breast, lung, lymphoma, and colorectal cancer faced the highest total treatment and diagnosis costs.

The five most costly types of cancer among the pool of participants, in terms of dollars spent by private insurance companies, were:

• Breast cancer — $3.4 billion, a median cost of $6,601 per person
• Lung cancer — $1.1 billion, a median of $27,334 per person
• Colorectal cancer — $1.1 billion, a median of $10,613 per person
• Lymphoma — $1.02 billion, a median of $7,803 per person
• Prostate — $832 million, a median of $4,722 per person

Pancreatic cancer had the highest median cost per person at $32,806.

Based on those numbers, researchers estimate that U.S. insurance companies paid a total of $156.2 billion for services for adults under 65 with the 15 most prevalent types of cancers in 2018. The total estimated costs, by cancer type, were:

• Breast cancer — $40.6 billion
• Prostate cancer — $19.4 billion
• Colorectal cancer — $19.2 billion
• Lung cancer — $15.1 billion
• Lymphoma — $12.6 billion

As another analysis found people under 65 have fewer cancer diagnoses than those over 65, but the former pay more for care over the duration of their lives.

How Money Is Spent After a Diagnosis

Dr. Zaorsky, the primary author of the report, told U.S. News & World Report, “We wanted to look at what private insurances are paying for each kind of cancer and for each type of service.”

The survey found that among the people in the MarketScan database, those with breast, colorectal, and prostate cancer received the highest total number of procedures. The types of cancer with highest total number of procedures required were:

• Breast cancer — 10.9 million, a median of 28 per person
• Colorectal cancer — 3.9 million, a median of 34 per person
• Prostate cancer — 3.6 million, a median of 24 per person
• Lymphoma — Around 3.5 million, a median of 30 per person
• Lung cancer — Around 3 million, a median of 53 per person

Liver cancer had the highest median number of procedures per person at 62.

In the case of lung cancer, Dr. Zaorsky and his team found that the majority of services were related to pathology and diagnosis, while other major services included radiology, management, and pharmaceutical treatments. In terms of cost, lung cancer comes in second only to breast cancer, racking up the majority of costs for radiology and pharmaceutical drugs.

The research team did not suggest cost-reducing measures. “It’s hard to say … what is a reasonable price for a drug or service, but I think it’s fair to say that they make up the plurality of our health care spending in the U.S., then some would argue that this money may be better spent elsewhere in other services,” Dr. Zaorsky told U.S. News & World Report. “These figures basically just show you how much the medical system spends on certain types of cancers versus another one.”

The report, titled "Medical Service Use and Charges for Cancer Care in 2018 for Privately Insured Patients Younger Than 65 Years in the US," is available on JAMA Network Open.