A new analysis examines cost changes for diseases tracked in the federal Bureau of Labor Statistics' Disease Based Price Indexes.
The average cost of treating disease in the United States increased 60% from 1999 to 2022, according to a new report by HealthCare.com.
The United States spends more on healthcare services than any other country. In 2022, national health expenditures are expected to increase at 4.6%, driven in part by higher healthcare prices linked to inflation in the economy, according to a recent analysis by the Centers for Medicare & Medicaid Services. Healthcare spending is expected to total $4.5 trillion this year, the CMS analysis found.
The new report is based on an analysis of the federal Bureau of Labor Statistics' Disease Based Price Indexes. The federal data tracks the costs to treat 115 diseases.
The new report has several key data points.
- The average cost of treating disease increased 1.6 times from 1999 to 2022
- Intestinal infections experienced the largest treatment cost increase, rising 4.3 times from 1999 to 2022
- After intestinal infections, the two diseases that experienced the largest treatment cost increases were tonsillitis (4.19 times increase) and diseases of the mouth excluding dental (4.16 times increase)
- Diabetes with complications experienced the largest treatment cost decrease, falling to 0.2 in 2022 compared to a base treatment cost of 1 in 1999
- After diabetes with complications, the two diseases that experienced the largest treatment cost decreases were heart attack (0.39 times decrease) and arterial blood clot (0.52 times decrease)
- For disease categories, "symptoms; signs; and ill-defined conditions" experienced the largest treatment cost increase, rising 2.4 times from 1999 to 2022
- For disease categories, cancer experienced the largest treatment cost decrease, falling to 0.9 times what it cost to treat in 1999
Interpreting the data
The causes of increasing cost for treating disease include three factors, says Dan Grunebaum, MS, a data journalist at HealthCare.com. "Inflation in the cost of goods and services needed to treat a disease is one factor that can lead to an increase in treatment cost. Another factor is that treatments can become more intensive due to rising disease severity, and thus more costly. A third factor is that the medical coding of diseases can change over time, making them appear more costly to treat in the index.
Similar factors contribute to decreasing cost for treating disease, he says. "The cost of goods and services needed to treat a disease can go down. For example, a drug can go generic and drop in price. Alternatively, treatments can become less intensive due lower disease severity. Another factor is technological advances in treatment leading to cost declines. Finally, changes in coding diseases can make treatment cheaper. For example, a milder level of diabetes that was previously coded as 'diabetes' is recoded as 'diabetes with complications,' making 'diabetes with complications' effectively more costly to treat."
The data on diseases that experienced the biggest increases in treatment cost reflect three trends, Grunebaum says.
- "One of the main trends seen in diseases that increased the most in treatment cost is increasing severity of the disease. In the index, intestinal infections, including common bugs like E. coli, saw the most growth in treatment cost, rising 4.3 times by 2022 against the base of 1 in 1999. Bureau of Labor Statistics economist Brett Matsumoto told us, 'This is consistent with more severe infections becoming relatively more common. For intestinal infections, the increase in utilization appears to be driven by an increase in inpatient hospitalizations and emergency room visits.'"
- "Consistent with the large rise in cost of treating intestinal infections is the fact that three out of five diseases to see the greatest percent growth are conditions of the digestive system."
- "Looked at by disease category, infectious and parasitic diseases show the fourth largest growth in cost. It is possible that the rise of antibiotic resistant bacteria is partly behind the increase in severity and cost of treating infections."
The data on diseases that experienced the biggest decreases in treatment cost reflect three trends, Grunebaum says.
- "Technological advances leading to treatments being performed in less intensive settings, such as outpatient instead of inpatient, is one trend behind large decreases in treatment costs."
- "The substitution of cheaper generics for expensive drugs is another trend."
- "Finally, better preventive care is an important trend lowering treatment costs for some diseases. Two out of the five diseases to see the most decrease in treatment costs are circulatory illnesses. Harvard health economist David Cutler notes in the [report] that, 'The number of people having heart attacks and strokes is way down. Part of that is because we have much better preventive care. That's a huge factor in medical care: the ability to prevent and treat cardiovascular events. And that's having a huge effect on spending.'"
Christopher Cheney is the senior clinical care editor at HealthLeaders.
Intestinal infections experienced the largest treatment cost increase, rising 4.3 times from 1999 to 2022.
Diabetes with complications experienced the largest treatment cost decrease, falling to 0.2 in 2022 compared to a base treatment cost of 1 in 1999.
One of the main factors driving increased treatment costs for diseases is increasing severity of the diseases.