Introduction: The Central Brain Tumor Registry of the United States (CBTRUS) estimates 79,270 new cases of primary brain tumors will be diagnosed within the US during 2017 (1). Few studies have evaluated overall healthcare expenditures for patients with brain tumors. Therefore, our objective was to study per-user healthcare expenditures for benign and malignant brain tumors related to emergency, inpatient, outpatient, and pharmaceutical services.

Methods: Data from the Medical Expenditure Panel Survey (MEPS) were analyzed. Brain tumor related emergency department (ER) visits, inpatient stays, outpatient visits, and prescription medications were identified using self-reported medical conditions converted to ICD-9-CM codes. Linear regression analyses controlling for age, sex, marital status, race, education, region of the country, insurance status, and healthcare utilization were used to examine inflation-adjusted per-user expenditures for patients with benign and malignant brain tumors.

Results: There were an estimated 52,142 persons with 21,503 (41.24%) benign and 30,639 (58.76%) malignant brain tumors in the MEPS database between 1996-2014. Mean total healthcare expenditures per patient were $24,273.00. Patients with malignant brain tumors had higher per-user healthcare expenditures for ER ($304.17 vs. $119.85; p<0.001), inpatient ($18,837.00 vs. $5,714.49; p<0.001), outpatient ($3,624.63 vs. $1,172.98; p<0.001), and overall care ($33,241.00 vs. $11,494; p<0.001). Patients with benign brain tumors had higher prescription medication expenditures ($2,893.89 vs. $1,864.33; p<0.001). In multivariable analysis, brain tumor type was only significantly associated with higher total per-user healthcare expenditures for patients with malignant brain tumors when compared to those with benign brain tumors (beta: 0.50; SE: 0.05; p<0.01)

Conclusions: This study is one of the first to investigate healthcare expenditures for brain tumors within a nationally representative sample. After controlling for covariates, the total per-user healthcare expenditures for patients with malignant brain tumors were substantially higher than those with benign brain tumors.

Patient Care: The costs related to therapeutic options for patients with benign and malignant brain tumors is not entirely understood. Most cost studies to date have focused on particular brain tumor subtypes, surgical approaches, or the administration of certain chemotherapeutic agents. Little is known about the overall economic impact of benign and malignant brain tumors within the United States. Therefore, our study’s estimates of per-user healthcare expenditures for those with benign and malignant brain tumors will help inform patients, clinicians, and policy makers in better aligning value within the clinical practice for patients with these tumors.

Learning Objectives: At the conclusion of this session, participants should be able to: 1) provide estimates for emergency, inpatient, outpatient, and pharmaceutical per-user healthcare expenditures related to the treatment of benign and malignant brain tumors; and 2) understand the factors significantly associated with higher healthcare expenditures for patients seeking care of benign and malignant brain tumors.

References: (1) Quinn T. Ostrom, Haley Gittleman, Jordan Xu, Courtney Kromer, Yingli Wolinsky, Carol Kruchko, and Jill S. Barnholtz-Sloan, CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2009–2013, Neuro Oncol (2016) 18 (suppl 5): v1-v75 doi: 10.1093/neuonc/nov207.