Overview of methods to estimate the medical costs of cancer.

BACKGROUND: Methods to estimate the direct medical costs of cancer care have evolved into several commonly used methods. OBJECTIVES: We describe the different estimation techniques briefly to contrast these approaches and provide a framework for other articles in this monograph. MEASURES AND RESULTS: One can estimate costs for all individuals with a specific cancer in a fixed calendar period (prevalent costs) or describe costs starting at the point of diagnosis and estimate immediate and long-term costs (incident costs). A variant of the incidence approach is to divide cancer care into initial, continuing, and terminal care phases and apply these phase-specific cost estimates to survival probabilities. The additional burden because of the cancer may be computed using cancer services (attributable costs) or by subtracting costs of healthy matched individuals (net costs). CONCLUSIONS: The strengths and weaknesses of these approaches are illustrated to show that the most appropriate choice will depend on whether the goal is to plan for health care costs, set public policy, or assess impact of potential interventions.