Online Program

Trends in Military Health System Costs for Colorectal Cancers, FY07-FY14

Monday, November 2, 2015

Michelle Kloc, Ph.D., MSN, RN, Evaluation and Measurement, Altarum Institute, Alexandria, VA
Diana Jeffery, PhD, Defense Health Agency,Clinical Support Division, Healthcare Operations Directorate, Department of Defense, Falls Church, VA
Joseph Dorris, MA, Altarum Institute, Ann Arbor, MI
Objective: This study examines the trends in costs for colorectal cancer (CRCa) patients receiving care in the Military Health System (MHS), by age group and sex from fiscal years (FY) 2007 – 2014.

Study Design: Principle ICD-9 codes for claims paid by TRICARE in FY07-14 were obtained from the MHS Master Data Repository.  CRCa diagnoses were identified using AHRQ Clinical Classification Software. Non-pharmacy and pharmacy costs were examined separately; costs were for all claims submitted by CRca patients.  .Bivariate and trend analysis were conducted. MHS beneficiaries ages 18 to 64, residing within the United States, were included if they accessed the healthcare system within the FY; incident and prevalence cases with CRca were included.

Principal Findings: Annual sample size of CRCa patients was approximately 7,881. .Non-pharmacy costs for CRCa patients decreased 1% between FY07-14; total pharmacy costs (all scripts) increased 42%. Per person non-pharmacy costs for ages 18-30 decreased 49% for females, but increased 72% for males. Inpatient costs increased over time. Non-pharmacy average per person costs for females were lower than for males. Per person pharmacy costs increased by 41% between FY07-14. Average per person pharmacy costs for males was slightly higher than for females and had greater variation over time.

Conclusions: Increased DoD total costs for beneficiaries diagnosed with  CRca appear to be driven by inpatient costs and  pharmacy costs, especially among males.

Implications for Policy or Practice: Updates in clinical guidelines and pharmaceutical treatment options may important cost implications, which may be seen mostly clearly by age group or gender.

Learning Areas:

Biostatistics, economics

Learning Objectives:
Describe gender and age group differences in prevalence, cost and utilization for colorectal cancer patients. Describe trends in prevalence, cost and utilization for colorectal cancer patients over time. Explain pharmacy and non-pharmacy drivers of costs, including differences by age group and gender.

Keyword(s): Cancer, Health Care Costs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been research lead or associate investigator for multiple DoD-funded projects and studies focused on analysis of TRICARE administrative claims data. A primary focus of my research is analysis of condition-specific prevalence and associated health care utilization and costs for military health system beneficiaries. I have a PhD in health policy and a clinical background to inform this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.