Costs of Complementary and Alternative Medicine for Cancer Survivors in the United States: Results from the 2012 National Health Interview Survey

Abstract

Purpose: While it is known that a high percentage of cancer survivors use complementary and alternative medicine (CAM), little is known about the financial implications of such use. We sought to determine cancer survivors' annual out-of-pocket spending on CAM. Methods: Data from the Adult Alternative Medicine questionnaire of the 2012 National Health Interview Survey (NHIS) were used to estimate out-of-pocket CAM costs among individuals with a history of a cancer diagnosis. The analysis was limited to adults with a history of cancer, excluding nonmelanoma skin cancers. Statistical methods were used to account for NHIS's complex sampling methods. We performed a multivariate analysis to determine factors associated with the highest quartile of CAM spending. Results: We identified a cohort of 3,102 cancer survivors, of which 78.1% reported having used at least one CAM modality over the past 12 months. We estimated that adult cancer survivors in the United States spent $9.0 billion in total on out-ofpocket CAM use in 2012. Over two thirds of this total was spent on the purchase of vitamins and minerals ($6.2 billion), over 15% ($1.4 billion) was spent on herbs and non-vitamin supplements, and over 5% ($0.5 billion) was spent on massage. Breast cancer survivors were estimated to be the highest spending group, totaling $1.6 billion in out-of-pocket CAM costs over the past 12 months. Among all users, median annual cost of CAM use was estimated at $140. Compared to those who did not report CAM use due to their cancer diagnosis, survivors who reported using any CAM for cancer have 4.6 times the odds of being a high spender (p = 0.0028). Conclusion: The total 2012 out-of-pocket CAM costs for cancer survivors in the United States are estimated to be $9.0 billion- 7% of the estimated $125 billion for cancer survivors' yearly health care costs.