Creating A Business Case for Cancer Control in Wyoming

1. Creating A Business Case for Cancer Control in Wyoming Kimberly Rogers Wyoming Comprehensive Cancer Control Program Manager Wyoming Department of Health (307)777.8609

2. What is the burden of cancer in Wyoming? • In 2003, a total of 2,241 new cancer cases were reported in Wyoming. In addition, in 2003, a total of 935 Wyoming people died as a result of cancer; • ACS estimates 2,500 new cancer cases will be diagnosed and 1,110 Wyoming people will die of the disease in 2006.

3. Top 5 Cancer SitesIncidence & Mortality (2003) *** Cervical Cancer data is challenging because only invasive cancers are reportable. Thus the number of pre-cancerous and in-situ cancers is unknown. The WBCCEDP funded 897 Pap tests in 2004. Although no cervical cancer cases were diagnosed, 41 pre-cancer cases were identified and treated. 65% of these women were between the ages of 20-30 years old.

4. What is the estimated financial impact of cancer in Wyoming ? • ** The above estimates were calculated and projected based on national data provided in The Cancer Atlas, a publication by the American Cancer Society, US Department of Health & Human Services, Centers for Disease Control & Prevention, World Health Organization & the UICC.

5. Direct Cost vs. Indirect Cost Estimate in Wyoming DirectIndirectTotal $127,145,247 $233,506,097 $360,651,344 Direct Costs: Payments and resources utilized for treatment, care and rehabilitation directly related to the illness. Indirect Costs: Loss of economic output due to days off work and premature death. Also included in this estimate are hidden costs such as health insurance premiums, and non-medical expenses (transportation, wigs, child or elder care, housekeeping assistance, ostomy supplies, prostheses).

6. Is Early Detection Cost Effective? • Milliman Report, 2005 • Report presents estimated costs and benefits of prevention, cancer screening / early detection for employee benefit programs. • Focuses on breast, cervical, and colorectal cancer screening (USPSTF has established evidence-based screening methods); • Focuses on prostate screening ONLY because it is covered in most health plans.

7. Findings of report • Cancer Prevention and Early Detection is Low Cost; • The Cost of People with Cancer is High; • Medical costs • Lost productivity • Short and long term disability • Life insurance • Investment in Prevention and Early Detection Makes Financial Sense.

8. Screening Costs PMPM Table 1: Screening Costs* PMPM with 100% Compliance for a Typical Employer

9. Table 2: Current Spending on Elective Prostate Cancer Screening

10. People with cancer only represent about 1.6% of the commercial population but generate about 10% of an employer/insurer’s annual medical claim costs.

11. Table 4: Comparing Costs of People with Cancer to People without Cancer

13. The Bottom Line • Estimated cost of direct and indirect costs of treatment in Wyoming far exceeds the cost of prevention and early detection of cancer; • Early screening suggests a greater opportunity for less aggressive and costly treatment; • The investment we make in CCC is a long-term investment and will contribute to overall health and well-being in Wyoming.

14. Utilizing a comprehensive multi-level systems approach to communicate CCC business case at a grassroots level.