The cost of treating virtually every ailment is going up.By Robert Langreth, Forbes.
One way to reduce health care costs would be to find diseases with the most rapidly rising costs and target them for cuts. Unfortunately, the costs for treating pretty much every disease are growing rapidly—and for a bewildering variety of reasons.
In the effort to overhaul America's health care system and the associated costs, this is not welcome news.
It isn't just the high-profile, often terminal ailments that are getting pricier to treat. Sure, costs for treating diseases like colon cancer are growing because fancy new drugs make each case much more expensive (drugs such as Erbitux for colon cancer can cost well over $50,000 per year). Simple, everyday problems cost more to treat too. Diseases like heartburn and high cholesterol are getting more expensive because more people are being treated. Total medical costs grew at a 7 percent rate between 1996 and 2005.
There are so many relentless forces toward rising costs, says Charles Roehrig, health economist at the Altarum Institute in Ann Arbor, Mich. He led a team that compiled the most-expensive-diseases list earlier this year as part of a study in the journal Health Affairs. Expenses for some diseases are growing because prevalence has gone up, and some are growing because the cost per case has come up," he says. "It is very hard to pinpoint a leverage point.
Behind the Numbers
The list of the 10 most expensive diseases are Roehrig's estimates, based on 2005 data, and is purportedly the most accurate compilation of disease-by-disease health costs to date. Previous government surveys included community-dwelling patients using data from the federal Medical Expenditure Panel Survey. Roehrig's estimate, however, provides a fuller picture by also accounting for costs of treating patients in nursing homes, the military, prisons and mental hospitals.
Nursing-home expenses explain why spending on mental health disorders such as depression, anxiety and Alzheimer's disease rise to the top of the list. They accounted for $142.2 billion in spending, vs. $123 billion of spending on second-place heart disease.
Previous surveys with 1997 and 2005 data by the Agency for Healthcare Research and Quality had heart disease at the top, but these lists didn't include the nursing-home-specific expenses, so may not have captured as much of the spending on Alzheimer's disease.
Trauma edges out cancer to take third place, with $100.2 billion in 2005 spending. While airbags, anti-lock brakes and other safety innovations have made cars safer, costs per trauma case are going up, Roehrig says. He's not sure why, but it is likely due to soaring usage of expensive imaging machines and ever-increasing costs of hospital care.
Of course, how you count determines what diseases appear on the list as expensive.
The costs of treating upper gastrointestinal problems surged to $32.7 billion in 2005 from $10.5 billion in 1996—a 14 percent annual growth rate. The obesity epidemic and exploding use of heartburn drugs mean more people are being treated. But it does not make the list of most expensive diseases because upper GI problems aren't considered one disease according to the government methodology.
Meanwhile, diabetes wracks up only $35.8 billion in annual expenses. Its main complication is heart disease, whose costs are counted separately.
The truly unfortunate part, however, is that Roehrig says he doesn't know whether current versions of health care reform will slow surging health costs or not.
The legislation is bewildering," he says. "It is impossible to know if the elements in health reform that are designed to save money are going to be successful.
The 5 Most Expensive Diseases: