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Healthcare expenditures were 55% higher among CCW compared to BCW. Similarly, healthcare expenditures were 57% higher among CCM compared to PCM. Further, CCW and CCM had 67% and 68% higher inpatient CAD-related expenditures compared to BCW and PCM, respectively. However, there was no significant difference between CCW and BCW as well as CCM and PCM for outpatient healthcare expenditures.

Figure 4.2. Weighted Average CAD-related Expenditures among Cancer and Non-cancer Cohorts across 120-day intervals

Note: Based on 46,332 elderly fee-for-service Medicare beneficiaries with pre-existing CAD between 2008 and 2011 (12,095 cancer cohort and 34,237 non- cancer cohort).

Individuals with incident breast, colorectal, and prostate cancer were derived from the SEER registries and individuals with no cancer were derived from the 5% non-cancer sample from the SEER region. Weights were derived using the Inverse Probability Treatment Weights approach.

Asterisks represent significant differences in cancer and non-cancer groups.

***p < 0.001; **0.001 ≤ p < 0.01; *0.01 ≤ p < 0.05

BCW: Women with breast cancer; CAD: Coronary artery disease; CCM: Men with colorectal cancer; CCW: Women with colorectal cancer; FFS: Fee-for- service; NCM: Men with no cancer; NCW: Women with no cancer; PCM: Men with prostate cancer; SEER: Surveillance, Epidemiology and End Results; Wt.: Weighted

Table 4.4. Parameter Estimates from Generalized Linear Mixed Models on CAD-related Expenditures with IPTW

Cancer dx

categories Coefficient Std error P value % change Cancer versus non-cancer differences in expenditures (Reference: NCW)a

BCW 0.13 0.04 0.002 14%

CCW 0.92 0.05 0.000 151%

Intercept 4.01 0.14

Cancer versus non-cancer differences in expenditures (Reference: NCM)b

CCM 0.97 0.05 0.000 164%

PCM 0.11 0.04 0.008 12%

Intercept 4.25 0.14

Sex differences in expenditures (Reference: NCM)c

NCW -0.24 0.03 0.000 -21%

Intercept 4.25 0.14

Sex differences in expenditures (References: CCM)d

CCW -0.29 0.07 0.000 -25%

Intercept 5.22 0.15

Cancer type differences in expenditures (Reference: BCW)e

CCW 0.79 0.06 0.000 55%

Intercept 4.93 0.15

Cancer type differences in expenditures (Reference: PCM)f

CCM 0.85 0.06 0.000 57%

Intercept 5.22 0.15

Note: Based on 46,332 elderly fee-for-service Medicare beneficiaries with pre-existing CAD between 2008 and 2011 (12,095 cancer cohort and 34,237 non-cancer cohort).

Individuals with incident breast, colorectal, and prostate cancer were derived from the SEER registries and individuals with no cancer were derived from the 5% non-cancer sample from the SEER region. Weights were derived using the Inverse Probability Treatment Weights approach. Adjusted models controlled for time, predisposing, enabling, need, healthcare behavior, healthcare use, and environmental factors.

Significance was derived from adjusted generalized linear model with Gamma distribution and log-link. The analysis used 6 repeated measures.

% Change for GLMM was calculated as (e(intercept + β) – eintercept_)/eintercept_.

a _{Other categories not displayed are: CCM, PCM, and NCM.} b _{Other categories not displayed are: BCW, CCW, and NCW.} c _{Other categories not displayed are: BCW, CCW, CCM, and PCM.} d _{Other categories not displayed are: BCW, PCM, NCW, and NCM.} e _{Other categories not displayed are: CCM, PCM, NCW, and NCM.} f _{Other categories not displayed are: BCW, CCW, NCW, and NCM.}

Abbreviations

BCW: Women with breast cancer; CAD: Coronary artery disease; CCM: Men with colorectal cancer; CCW: Women with colorectal cancer; FFS: Fee-for-service; GLMM: Generalized linear mixed models; IPTW: Inverse Probability Treatment Weights; NCM: Men with no cancer; NCW: Women with no cancer; PCM: Men with prostate cancer; SE: Standard error; SEER: Surveillance, Epidemiology and End Results; Wt.: Weighted

Table 4.5. Parameter Estimates from Generalized Linear Mixed Models on CAD-related Expenditures with IPTW Cancer dx categories Inpatient CAD-related expenditures Outpatient CAD-related expenditures

Coefficient Std error P value Change Coefficient Std error P value Change Cancer versus non-cancer differences in expenditures (Reference: NCW)a

BCW 0.11 0.08 0.15 12% 0.43 0.04 0.000 54%

CCW 1.22 0.08 0.000 239% 0.39 0.05 0.000 48%

Intercept 2.36 0.20 3.13 0.12

Cancer versus non-cancer differences in expenditures (Reference: NCM)b

CCM 1.25 0.08 0.000 249% 0.41 0.06 0.000 51%

PCM 0.10 0.07 0.152 11% 0.27 0.04 0.000 31%

Intercept 2.71 0.20 3.47 0.11

Sex differences in expenditures (Reference: NCM)c

NCW -0.35 0.06 0.000 -30% -0.35 0.03 0.000 -30%

Intercept 2.71 0.20 3.47 0.11

Sex differences in expenditures (Reference: CCM)d

CCW -0.38 0.10 0.000 -32% -0.37 0.07 0.000 -31%

Intercept 3.96 0.21 3.89 0.13

Cancer type differences in expenditures (Reference: BCW)e

CCW 1.11 0.1 0.000 67% -0.04 0.06 0.522 -4%

Intercept 3.58 0.21 3.52 0.13

Cancer type differences in expenditures (Reference: PCM)f

CCM 1.14 0.09 0.000 68% 0.14 0.09 0.056 13%

Intercept 3.96 0.21 3.89 0.13

Note: Based on 46,332 elderly fee-for-service Medicare beneficiaries with pre-existing CAD between 2008 and 2011 (12,095 cancer cohort and 34,237 non- cancer cohort).

Individuals with incident breast, colorectal, and prostate cancer were derived from the SEER registries and individuals with no cancer were derived from the 5% non-cancer sample from the SEER region. Weights were derived using the Inverse Probability Treatment Weights approach. Adjusted models controlled for time, predisposing, enabling, need, healthcare behavior, healthcare use, and environmental factors.

a_{Other categories not displayed are: CCM, PCM, and NCM.} b_{Other categories not displayed are: BCW, CCW, and NCW.} c_{Other categories not displayed are: BCW, CCW, CCM, and PCM.} d_{Other categories not displayed are: BCW, PCM, NCW, and NCM.} e_{Other categories not displayed are: CCM, PCM, NCW, and NCM.}

f_{Other categories not displayed are: BCW, CCW, NCW, and NCM.}

Significance was derived from adjusted generalized linear model with Gamma distribution and log-link. The analysis used 6 repeated measures. % Change for GLMM was calculated as (e(intercept + β) – eintercept_)/eintercept_.

Abbreviations

BCW: Women with breast cancer; CAD: Coronary artery disease; CCM: Men with colorectal cancer; CCW: Women with colorectal cancer; FFS: Fee-for- service; IPTW: Inverse Probability Treatment Weights; NCM: Men with no cancer; NCW: Women with no cancer; PCM: Men with prostate cancer; SEER: Surveillance, Epidemiology and End Results; Wt.: Weighted