Cancer Research and Treatment

Original Articles

General

Recent Trends of Medical Expenses Associated with Radiation Therapy in Korea Based on HIRA Big Data: Jeong Eun Lee, Kyungmi Yang, Yong Chan Ahn, Won Park, Seung Jae Huh; Cancer Res Treat. 2023;55(3):758-765. Published online January 30, 2023; DOI: https://doi.org/10.4143/crt.2022.389

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Purpose
We aimed to determine the trends in the use of radiotherapy (RT) and the expenses associated with it in South Korea.
Materials and Methods
The statistical data of the claims and reimbursement records provided on the Health and Insurance Review and Assessment Service website were utilized. This included information such as the number of patients, fractions, medical expenses according to treatment codes, in/outpatient, sex, age, and regions of hospitals. We analyzed data from 2016 to 2020.
Results
With a growing RT infrastructure and an increase in the number of radiation oncologists, the expenses for RT were 605.5 million USD in 2020, which had increased 1.5 times from 394.7 million USD in 2016. This growth was mainly because of the increased usage of advanced RT techniques. Furthermore, the proportion of intensity-modulated radiation therapy (IMRT) expenses in the total expenses increased by 1.6 times from 48.8% in 2016 to 76.9% in 2020. Advanced techniques were used more commonly in older individuals or children. However, the proportion of IMRT expenses increased mostly in young women. Additionally, geographical differences in RT use and expense were observed, although the gap in the IMRT fractions decreased among the regions.
Conclusion
Recent medical expenses associated with RT in Korea have increased in tandem with technological advances and changes in demographics.

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Volumetric Modulated Arc Therapy for 26 Gy in 5 Fractions Whole Breast Irradiation for Breast Cancer
Seo Hee Choi, Jin Sung Kim, Ho Jin Kim, Ryeong Hwang Park, Ik Jae Lee, Yong Bae Kim, Jee Suk Chang
Advances in Radiation Oncology.2025; 10(4): 101733. CrossRef
Large institutional experience of early outcomes and dosimetric findings with postoperative stereotactic partial breast irradiation in breast cancer
Jee Suk Chang, Jeongshim Lee, Frank A. Vicini, Jin Sung Kim, Jihun Kim, Seo Hee Choi, Ik Jae Lee, Yong Bae Kim
Radiotherapy and Oncology.2024; 191: 110066. CrossRef

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Medical Costs and Healthcare Utilization among Cancer Decedents in the Last Year of Life in 2009: Inuk Hwang, Dong Wook Shin, Kyoung Hee Kang, Hyung Kook Yang, So Young Kim, Jong-Hyock Park; Cancer Res Treat. 2016;48(1):365-375. Published online March 2, 2015; DOI: https://doi.org/10.4143/crt.2014.088

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Purpose
The purpose of this study was to evaluate the cancer care cost during the last year of life of patients in Korea. Materials and Methods We studied the breakdown of spending on the components of cancer care. Cancer decedents in 2009 were identified from the Korean Central Cancer Registry and linked with the Korean National Health Insurance Claims Database. The final number of patients included in the study was 70,558.
Results
In 2009, the average cancer care cost during the last year of life was US $15,720. Patients under age 20 spent US $53,890 while those 70 or over spent US $11,801. Those with leukemia incurred the highest costs (US $43,219) while bladder cancer patients spent the least (US $13,155). General costs, drugs other than analgesics, and test fees were relatively high (29.7%, 23.8%, and 20.7% of total medical costs, respectively). Analgesic drugs, rehabilitation, and psychotherapy were still relatively low (4.3%, 0.7%, and 0.1%, respectively). Among the results of multiple regression analysis, few were notable. Age was found to be negatively related to cancer care costs while income level was positively associated. Those classified under distant Surveillance, Epidemiology, and End Results stages of cancer and higher comorbidity level also incurred higher cancer care costs. Conclusion Average cancer care costs varied significantly by patient characteristics. However, the study results suggest an underutilization of support services likely due to lack of alternative accommodations for terminal cancer patients. Further examination of utilization patterns of healthcare resources will help provide tailored evidence for policymakers in efforts to reduce the burdens of cancer care.

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Patterns of Medical Utilization in Children, Adolescents, and Young Adults With Life-Limiting Conditions in Korea: A Cohort Study Based on National Health Insurance Data
Seonhwa Lee, Byungmi Kim, Jin Young Choi, So-Jung Park, Jun Ah Lee, Chung Ho Kim, Bomi Park, Bohyun Park
Journal of Korean Medical Science.2025;[Epub] CrossRef
Medical care costs at the end of life among older adults with cancer: a national health insurance data-based cohort study
Minjeong Jo, Yunji Lee, Taehwa Kim
BMC Palliative Care.2023;[Epub] CrossRef
Medical cost of advanced illnesses in the last-year of life—retrospective database study
Palvinder Kaur, Huei Yaw Wu, Allyn Hum, Bee Hoon Heng, Woan Shin Tan
Age and Ageing.2022;[Epub] CrossRef
Projecting Lifetime Health Outcomes and Costs Associated with the Ambient Fine Particulate Matter Exposure among Adult Women in Korea
Gyeyoung Choi, Yujeong Kim, Gyeongseon Shin, SeungJin Bae
International Journal of Environmental Research and Public Health.2022; 19(5): 2494. CrossRef
Disparities in healthcare expenditures according to economic status in cancer patients undergoing end-of-life care
Kyu-Tae Han, Woorim Kim, Seungju Kim
BMC Cancer.2022;[Epub] CrossRef
Healthcare resource utilization and medical costs in patients with terminal cancer during best supportive care
Dong-Won Kang, Yoon-Bo Shim, Eui-Kyung Lee, Mi-Hai Park, Wen-Chi Chou
PLOS ONE.2022; 17(6): e0269565. CrossRef
Trends in End-of-Life Resource Utilization and Costs among Prostate Cancer Patients from 2006 to 2015: A Nationwide Population-Based Study
Yun-Sok Ha, So-Young Kim, Jae Il Chung, Hoon Choi, Jae Heon Kim, Ho Song Yu, In-Chang Cho, Hyung Joon Kim, Hyun Chul Chung, Jun Sung Koh, Ji Youl Lee, Dong Jin Park, Hyun Tae Kim, Eun Sang Yoo, Tae Gyun Kwon, Kyungchan Min, Wun-Jae Kim, Seok Joong Yun, Jo
The World Journal of Men's Health.2021; 39(1): 158. CrossRef
End-of-life cost trajectories and the trade-off between treatment costs and life-extension: Findings from the Cost and Medical Care of Patients with Advanced Serious Illness (COMPASS) cohort study
Brett Doble, Wei Han Melvin Wong, Eric Finkelstein
Palliative Medicine.2021; 35(5): 893. CrossRef
Evolution of health care utilization and expenditure during the year before death in 2015 among people with cancer: French snds-based cohort study
Audrey Tanguy-Melac, Dorian Verboux, Laurence Pestel, Anne Fagot-Campagna, Philippe Tuppin, Christelle Gastaldi-Ménager
The European Journal of Health Economics.2021; 22(7): 1039. CrossRef
How the resource allocation and inpatient behavior affect the expenditures of terminal malignant tumor patients?
Fen Li, Bifan Zhu, Peimin Sang, Chunlin Jin
Journal of Cancer Policy.2020; 25: 100249. CrossRef
Cost of Care and Pattern of Medical Care Use in the Last Year of Life among Long-Term Care Insurance Beneficiaries in South Korea: Using National Claims Data
Sunjoo Boo, Jungah Lee, Hyunjin Oh
International Journal of Environmental Research and Public Health.2020; 17(23): 9078. CrossRef
The Last Year Before Graft Failure Negatively Impacts Economic Outcomes and is Associated With Greater Healthcare Resource Utilization Compared With Previous Years in the United Kingdom: Results of a Retrospective Observational Study
Gorden Muduma, Varuna Aluvihare, Marc Clancy, Enrico de Nigris, Carolyn Whitlock, Margarita Landeira, Jameel Nazir
Transplantation Direct.2019; 5(5): e443. CrossRef
National practice patterns and direct medical costs for prostate cancer in Korea across a 10 year period: a nationwide population-based study using a national health insurance database
Ho Won Kang, Seok-Joong Yun, Jae Il Chung, Hoon Choi, Jae Heon Kim, Ho Song Yu, Yun-Sok Ha, In-Chang Cho, Hyung Joon Kim, Hyun Chul Chung, Jun Sung Koh, Wun-Jae Kim, Jong-Hyock Park, Ji Youl Lee, So-Young Kim
BMC Health Services Research.2019;[Epub] CrossRef
Budget impact analysis of gene expression tests to aid therapy decisions for breast cancer patients in Germany
M.P. Lux, N. Nabieva, T. Hildebrandt, H. Rebscher, S. Kümmel, J.-U. Blohmer, M.G. Schrauder
The Breast.2018; 37: 89. CrossRef
Intensity of Care at the End of Life Among Older Adults in Korea
Su Hyun Kim, Sangwook Kang, Mi-Kyung Song
Journal of Palliative Care.2018; 33(1): 47. CrossRef
Gasto en el último año de vida para pacientes que mueren con cáncer
Sergio I. Prada, Juan F. Contreras
Revista Colombiana de Cancerología.2018; 22(1): 3. CrossRef
Medical care costs of cancer in the last year of life using national health insurance data in Korea
Mihai Park, Inmyung Song, M Barton Laws
PLOS ONE.2018; 13(6): e0197891. CrossRef
The Effect of Hospice Consultation on Aggressive Treatment of Lung Cancer
Shin Hye Yoo, Bhumsuk Keam, Miso Kim, Tae Min Kim, Dong-Wan Kim, Dae Seog Heo
Cancer Research and Treatment.2018; 50(3): 720. CrossRef
Evaluation of the Cost of Comprehensive Outpatient Therapies in Patients with Malignant Brain Tumors
Stacy McCarty, Susan Keeshin, Sarah M. Eickmeyer, Samman Shahpar, Patrick Semik, Alex W. K. Wong
American Journal of Physical Medicine & Rehabilitation.2017; 96(5): 341. CrossRef
Health care services utilization during the last 6 months of life among patients with bladder cancer who underwent radical cystectomy in Quebec, Canada
Ahmed S. Zakaria, Fabiano Santos, Alice Dragomir, Wassim Kassouf, Simon Tanguay, Armen Aprikian
Urologic Oncology: Seminars and Original Investigations.2017; 35(9): 539.e1. CrossRef
Joint Symposium of Korean Cancer Association & UICC-ARO—Cross-boundary cancer studies: cancer and Universal Health Coverage (UHC) in Asia
Eun-Cheol Park, Norie Kawahara, Shinjiro Nozaki, Hasbullah Thabrany, Shunya Yoshimi, Sohee Park, Duk Hyoung Lee, Hideyuki Akaza, Jae Kyung Roh
Japanese Journal of Clinical Oncology.2017; 47(9): 889. CrossRef
Escalating Health Care Expenditures in Cancer Decedents’ Last Year of Life: A Decade of Evidence from a Retrospective Population-Based Cohort Study in Taiwan
Yen-Ni Hung, Tsang-Wu Liu, Fur-Hsing Wen, Wen-Chi Chou, Siew Tzuh Tang
The Oncologist.2017; 22(4): 460. CrossRef

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The Impact of Molecularly Targeted Treatment on Direct Medical Costs in Patients with Advanced Non-small Cell Lung Cancer: June-Koo Lee, Dong-Wan Kim, Bhumsuk Keam, Tae Min Kim, Se-Hoon Lee, Young-Joo Kim, Dae Seog Heo; Cancer Res Treat. 2015;47(2):182-188. Published online September 12, 2014; DOI: https://doi.org/10.4143/crt.2013.227

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Purpose
To investigate the impact of targeted treatment on direct medical costs of patients with advanced non-small cell lung cancer (NSCLC). Materials and Methods Medical records of 108 stage IIIB/IV NSCLC patients treated in Seoul National University Hospital between 2003 and 2009, were reviewed to collect medical resources utilization data from the diagnosis of stage IIIB/IV NSCLC to the end of active anti-cancer treatment. The direct medical costs were calculated by multiplying the number of medical resources used by the unit price. All costs were expressed in US dollars for each patient. Results The mean total direct medical costs were $34,732 (standard deviation, 21,168) in the study cohort. The mean total direct medical costs were higher in epidermal growth factor receptor (EGFR) mutation (EGFR MT)–positive patients than EGFR wild-type (EGFR WT) patients ($41,403 vs. $30,146, p=0.005). However, the mean monthly direct medical costs did not differ significantly between EGFR MT–positive patients and EGFR WT patients ($2,120 vs. $2,702, p=0.119) because of the longer duration of active anti-cancer treatment in EGFR MT–positive patients. This discrepancy was mainly attributable to EGFR MT–positive patients’ lower non-chemotherapy costs ($948 vs. $1,522, p=0.007). The total and monthly direct medical costs of ALK fusion–positive patients who did not receive ALK inhibitors did not differ from WT/WT patients. Conclusion This study suggests that the availability of targeted agents for EGFR MT–positive patients lowers the mean monthly medical costs by prolonging survival and diminishing the use of other medical resources, despite the considerable drug costs.

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Treatment decisions, clinical outcomes, and pharmacoeconomics in the treatment of patients with EGFR mutated stage III/IV NSCLC in Germany: an observational study
Wolfgang Schuette, Peter Schirmacher, Wilfried E. E. Eberhardt, Manfred Dietel, Ute Zirrgiebel, Lars Muehlenhoff, Michael Thomas
BMC Cancer.2018;[Epub] CrossRef
Health care resource use among patients with advanced non-small cell lung cancer: the PIvOTAL retrospective observational study
Dae Ho Lee, Hiroshi Isobe, Hubert Wirtz, Sabina Bandeira Aleixo, Phillip Parente, Filippo de Marinis, Min Huang, Ashwini Arunachalam, Smita Kothari, Xiting Cao, Nello Donnini, Ann-Marie Woodgate, Javier de Castro
BMC Health Services Research.2018;[Epub] CrossRef

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