Expensive medical treatments have been in the news lately. Medicare debated whether it should reimburse the costs of a new drug for Alzheimer’s disease. Aduhelm is expensive and one wonders if it is effective. It is also not considered safe by some medical experts. The New York Times described the controversy: “Last year, Medicare’s actuarial division, acting without knowing what the coverage decision would be, imposed one of the largest-ever increases in Medicare Part B premiums for 2022, partly motivated by the possibility of coverage for Aduhelm, which at the time was priced by its manufacturer at $56,000 per year.
In a nutshell, the story shows the problem of how very expensive treatments are paid for. People can ask them to stay alive or lead a somewhat normal life. But who should pay them?
Some conditions can be much more expensive to treat than others. To identify the most expensive disease in America, 24/7 Tempo looked at cost per case dollars, which measures the amount of money spent per episode of care, for 256 detailed conditions treated in the United States in 2019 from the Health Care Satellite Account, a set of statistics measuring health care spending in the United States produced by the Bureau of Economic Analysis (BEA).
We used the office’s Blended Account database, which combines data from multiple sources, including large claims databases that cover millions of enrollees and billions of claims. To focus on specific conditions and diseases, we have excluded miscellaneous categories, such as “Other care and screening”. Additional data also comes from the BEA.
Although a few of these conditions, including some heart attacks and HIV, are known to be preventable, the majority of them are not. The causes of a wide range of cancers, as well as appendicitis and ulcerative colitis, are variable and poorly understood, meaning patients may have little control over their progression and therefore their need for expensive treatments. .
Some of the costliest conditions, including sickle cell anemia and cystic fibrosis, are inherited diseases. Although a healthy lifestyle is a key factor in preventing certain medical conditions, it often has little to do with some of the costliest diseases.
The most expensive medical treatment in America is for cystic fibrosis. Here are the details:
- Cost per care episode: $136,319
- Annual expenses on condition: $4,942,155,835 (185th out of 256 conditions)
- Weighted annual number of episodes: 36,254 (309th plus)
- Relative cost per case spend growth: #1 fastest
Click here to see all of the most expensive medical treatments in America.