Health care cost trajectories among patients with cancer and cardiometabolic comorbidities over a decade including the pandemic period.

The study population of 738,414 newly diagnosed cancer patients had high rates of cardiometabolic comorbidities, with hypertension being most prevalent.

• Mean age was 60.5 years (SD: 13.2)
• 42.4% had hypertension, 41.5% had hyperlipidemia, and 14.9% had diabetes
• 41.2% had none of these comorbidities
• Data were drawn from 2011-2021 MarketScan database with patients newly diagnosed annually from 2012 to 2020

Annual health care costs increased steadily from 2012 to 2018 across all comorbidity groups.

• Costs for patients with hypertension increased from $30,702 to $41,962 (APC: 5.5%)
• Costs for patients with hyperlipidemia increased from $29,353 to $40,510 (APC: 5.6%)
• Costs for patients with diabetes increased from $28,968 to $42,432 (APC: 6.2%)
• Among patients without these conditions, costs increased from approximately $26,856–$28,608 to $36,624–$38,620, with APCs of 5.1%–5.2%
• All costs were inflation-adjusted to 2021 US dollars

Annual health care costs declined substantially in the 2019 and 2020 cohorts, overlapping with the COVID-19 pandemic.

• Costs dropped to $30,992 for patients with hypertension (APC: -14.3%)
• Costs dropped to $29,332 for patients with hyperlipidemia (APC: -14.7%)
• Costs dropped to $31,301 for patients with diabetes (APC: -13.3%)
• Corresponding declines among patients without these conditions were to $26,003 (APC: -14.1%), $28,013 (APC: -13.6%), and $27,987 (APC: -14.5%)
• The 2019 and 2020 cohorts included patients assessed during the COVID-19 pandemic period

Patients with cancer and preexisting cardiometabolic comorbidities had significantly higher annual health care costs compared to those without these conditions.

• Patients with hypertension had 14% to 21% higher annual health care costs than those without hypertension
• Patients with hyperlipidemia had 4% to 8% higher annual health care costs than those without hyperlipidemia
• Patients with diabetes had 1% to 12% higher annual health care costs than those without diabetes
• Estimates were derived from generalized linear models reporting mean cost ratios

Outcomes were assessed across four categories of health care expenditure in the year following cancer diagnosis.

• Outcomes included inpatient, emergency department, outpatient, and pharmacy expenses
• Costs were incurred within 1 year after the cancer diagnosis
• Generalized linear models and Joinpoint models were used to estimate mean cost ratios and annual percentage changes (APCs)
• Preexisting comorbidities were identified in the year before the cancer diagnosis