Cancer Care Twice as Expensive in the U.S., But Mortality Rates Not Much Different

The financial impacts of a cancer diagnosis in the United States can be significant, with a 2018 study finding that 42% of Americans with cancer drain all their assets within two years of diagnosis. With such high costs in the U.S., a group of researchers set out to determine if this translated to better survival odds.

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Ryan Chow, lead author of the study and M.D./PhD student at Yale, says, “There is a common perception that the U.S. offers the most advanced cancer care in the world. Our system is touted for developing new treatments and getting them to patients more quickly than other countries. We were curious whether the substantial U.S. investment on cancer care is indeed associated with better cancer outcomes.”

To investigate this, Chow teamed up with other researchers from Yale and Vassar College to analyze cancer care costs and outcomes among 22 high-income nations. According to the findings, published in JAMA Health Forum, the U.S. spends, on average, twice as much as the other countries involved: More than $200 billion dollars annually, which translates to about $600 per person. Meanwhile, the average rate elsewhere was about $300 per person.

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Did this higher figure translate to lower mortality? Not significantly. Overall, the team found that mortality rates were only slightly lower in the U.S., and that six countries in the study – Australia, Finland, Iceland, Japan, Korea, and Switzerland – had lower spending and lower death rates.

The researchers also accounted for smoking, which tends to be less common in the U.S. than elsewhere. When they factored in international variations in smoking rates, they found that cancer mortality rates in the U.S. were the same as the average high-income country. There were also nine countries – Australia, Finland, Iceland, Japan, Korea, Luxembourg, Norway, Spain, and Switzerland – with lower smoking-adjusted cancer mortality rates.

The researchers say these findings show that changes to the American healthcare system may be needed.

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Elizabeth Bradley, co-author and president of Vassar College, explains, “The pattern of spending more and getting less is well-documented in the U.S. healthcare system; now we see it in cancer care, too. Other countries and systems have much to teach the U.S. if we could be open to change.”

While the team notes that more research is needed to pinpoint the financial issues within the U.S. health care system that could be reformed, lax regulation of cancer drug approvals and drug pricing appear to be playing a role.

The cost of care in the U.S. has traditionally caused patients to cut back on needed treatment. The CDC says about 3 in 10 cancer patients alter their treatment due to financial concerns. That may include rationing medicine, putting off filling prescriptions, using alternate therapies, or purchasing medications from other countries like Mexico or Canada.

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