Chronic Conditions – Cancer

Will you be one of the 40 percent of men or 38 percent of women who will develop cancer during their lifetime?  Or maybe you already are?  Cancer seems to touch everyone in some way, having affected a family member, friend or co-worker.  Cancer is the second most common cause of death in the US, exceeded only by heart disease.

And it is not stopping.  According to the American Cancer Society, there will be an estimated 1.7 million new cancer cases diagnosed in 2018 in the U.S., with 68,570 new cases in Ohio alone.  Additionally, they predict 2018 will see 609,640 cancer deaths in the United States.  That translates to about 1,670 deaths per day from cancer.

These are sobering statistics.

How can we stop it?

Cancer is the uncontrolled growth and spread of abnormal cells in the body.  Researchers have yet to determine the reason why this disease occurs; however, they know there are many risk factors that contribute to the disease.  These risk factors include lifestyle choices – tobacco use, poor diet and excess weight – along with non-modifiable factors such as inherited genetic mutations, hormones and immune conditions.  These risk factors are believed to work simultaneously or in sequence to initiate and/or promote cancer growth within the body.

A substantial proportion of cancer is preventable. 

According to a recent study by American Cancer Society epidemiologists, at least 42% of newly diagnosed cancers in the U.S. – about 729,000 cases in 2018 – are potentially avoidable, including:

  • 19 percent that are caused by smoking
  • 18 percent that are caused by a combination of excess body weight, physical inactivity, excess alcohol consumption, and poor nutrition

Certain cancers caused by infectious agents, such as human papillomavirus (HPV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Helicobacter pylori (H. pylori), could be prevented through behavioral changes, vaccination, or treatment of the infection.

Cancer Close to Home

Cancer affected 11,780 people in our data analytics book of business, 10.4% of the total population.  The good news is that this is actually a decrease of 3.2% from the prior 12-month period.

Although the number of members affected by cancer decreased, the cost of cancer treatments increased by 5.4 percent.  The 80 employers in our McGohan Brabender data analytics book of business spent $52.4 million on cancer in a 12-month period.  That is an average of $655,000 per employer and nearly 8% of total health care spend consumed by cancer alone.

The average cost per cancer patient admitted to a hospital was $21,700.  The average cost of a member taking cancer drugs was nearly $6,000.

Chronic Disease is expensive.  Imagine being able to reduce your spend on just the two most common lifestyle-related chronic conditions.  You could save around 17 percent of your health care spend, considering on average:

  • 9 percent of health care dollars are spent on heart disease
  • 8 percent of health care dollars are spent on cancer

And that doesn’t even take into account the indirect costs, which can be more expensive than the medical costs.  Cancer is one of the primary causes of short-term and long-term disability, both leading to losses in productivity.  Even when the member with cancer is not an employee, but a family member, there are losses in productivity.

As an employer, what can you do?

One of the most important cancer prevention strategies is early detection via preventive screenings.  Are your members having age-appropriate preventive screenings?  These include:

  • Mammogram
  • Pap Smear
  • Colonoscopy
  • PSA test (prostate)

Preventive care is cheap compared to treatment!

According to our data analytics, the average cost of a preventive screening digital, bilateral mammogram is:

  • Employer = $237
  • Employee = $0 (covered as preventive service)

What about the average cost of breast cancer?  A study published by American Health & Drug Benefits compared insurance claims from various women who had undergone breast cancer treatment and found some startling results. The average cost seen within the first year after receiving a diagnosis were as follows:

  • Stage 0 – $60,637
  • Stage I/II – $82,121
  • Stage III – $129,387
  • Stage IV – $134,682

Not only does early detection help to offset your medical costs to a significant extent, but it can also give you a better chance at overcoming your diagnosis.

How many of your members are having an annual physical with their doctor?   This is so important for maintaining health and managing disease.  Doctors will have a record of the patient’s health to note changes early.  They can persuade their patients to have preventive screenings, blood work and other tests needed for early disease detection.  And you can get them there!  Requiring employees and spouses to have an annual exam can be the easiest way to help lower health care costs for the company.  And even though you can’t force someone to see a doctor, there can be financial penalties for failing to have an annual exam, or incentives if they do.  In McGohan Brabender’s experience, paying higher premiums for non-compliant members is one of the best ways to ensure compliance.

 

*Image from University of Michigan Center for Chronic Disease