Healthcare Costs of Mental Health Conditions among Commercially Insured Cancer Survivors in the United States, 2012-2017

Abstract Purpose Only one-third of cancer survivors with a mental health condition receive mental health services for these conditions. Non-receipt of care may be associated, in part, with financial burden. This study compares the costs of all health care services received by cancer survivors with and without mental health conditions and examines the insurer and out-of-pocket (OOP) costs for mental health services among cancer survivors. We also examine variation in these costs by clinical, demographic, and socioeconomic factors. Methods We used the MarketScan Commercial Claims and Encounters Database 2012–2017 to compute adjusted annual costs reported in 2019 US$. Adjusted costs were estimated using the two-part model with age, sex, and number of comorbid conditions as independent variables. Results Cancer survivors with mental health conditions incur an additional $8,376 in total costs and $287 in OOP costs for all health care services compared to those without. Cancer survivors had higher total costs for mental health services, especially prescription drugs, compared to those without cancer or other chronic conditions. Costs vary by type of mental health condition, cancer type, demographics, and socioeconomic characteristics of the area where the patient resides. Conclusions Cancer survivors with mental health conditions incur higher healthcare costs than those without mental health conditions. These costs vary by demographic and socioeconomic factors. Targeting community and population specific interventions for cancer survivors with mental health conditions who are incurring the highest healthcare costs may help improve utilization of mental health services.