Utilization and Costs Among Bladder Cancer, Other Cancer, and Noncancer Populations in the United States

To investigate healthcare utilization (HCU) and expenditures across bladder cancer (BCa), other cancers, and noncancer groups and to assess for racial and ethnic disparities.

Using the Medical Expenditure Panel Survey (2015-2022), we identified 165,665 respondent-year observations from 85,194 unique individuals and categorized respondents as BCa, non-BCa cancers (prostate, colorectal, lung, melanoma, lymphoma, breast, gynecologic), or no cancer history. Survey-weighted regression models were used to compare and estimate incidence rate ratios of annual HCU (a composite of emergency, outpatient, inpatient encounters, prescriptions) and expenditures (total and out-of-pocket).

Among 165,665 respondent-years (mean age 55.7 years), 0.2% had BCa, 4.5% other cancers, and 95.3% no cancer. Compared to BCa, adjusted total composite physician interactions were similar in the no-cancer group (IRR 0.97, 95% CI 0.85-1.11) and the non-BCa cancers (IRR 1.10, 0.96-1.26). Non-BCa patients had fewer ED visits than BCa patients (IRR 0.65, 0.46-0.92). Compared to BCa patients, adjusted total spending was significantly lower in no-cancer patients (IRR 0.74, 0.59-0.91), whereas adjusted OOP spending did not differ. Total and OOP spending were also similar between BCa and non-BCa patients. Racial/ethnic minority patients had higher total physician interaction (IRR 1.97, 1.26-3.09), outpatient visits (IRR 2.54, 1.56-4.12) and total healthcare expenditures (IRR 1.73, 1.01-2.97) than non-Hispanic White patients.

BCa patients showed significantly higher HCU in emergency visits compared to both noncancer and other cancer patients. BCa patients did not incur higher expenses than other malignancies. Disparities in HCU and expenditure stratified by race/ethnicity were evident and most pronounced among BCa patients.