An Unhealthy America: The Economic Burden of ... - Milken Institute

An Unhealthy AmericaMilken InstituteProjections of Chronic Disease without Early Screening and TreatmentProjections of Chronic Disease without Early Screening and TreatmentExpendituresNew CasesPRC* Expenditures/PRCIncidence Rate**ThousandsPer 100,000 populationDisease(Billions) (Millions) (Thousands)Chronic Disease Year* Baseline Optimistic Baseline OptimisticBreast Cancer Cancer 2003 200 48.1 200 10.6 135.5 4.5 135.5Breast Cancer2013 2575.52511.1159.24.8155.72023 302 265 172.7 151.4Lung CancerColon Cancer 2003 185 3.9 185 0.3 63.5 11.5 63.5Lung Cancer 2013 202 6.3 186 0.4 63.7 17.1 58.62023 247 202 71.9 58.6Prostate Cancer 4.3 1.0 4.1Other Cancers 2003 619 619 212.7 212.7Other Cancers 2013 831 28.0 765 7.7 262.2 3.6 241.3Pulmonary Conditions2023 1,02145.273549.2296.90.9213.7Cases with DiagnosisPrevalenceDiabetes 27.1 13.7 2.0ThousandsPercent of U.S. population 25 and overChronic Disease HypertensionYear*Baseline 32.5 Optimistic 36.8Baseline 0.9 OptimisticPulmonary Heart Conditions Disease 2003 29,071 64.7 29,071 19.2 15.4 3.4 15.42013 32,887 31,086 15.6 14.8Stroke 13.6 2.4 5.62023 38,162 32,799 16.5 14.2Diabetes Mental Disorders 2003 14,559 45.8 14,559 30.3 7.7 1.5 7.7Total2013 18,825277.018,341 162.28.91.78.72023 22,261 19,301 9.6 8.3*Selected years PRC: for twenty-year Population projection Reporting Condition** Female population was used for breast cancer.Source: Milken InstituteSimulations Based on the Three ModelsUtilizing the three preceding models—two of which include their own baseline and optimistic assumptions—it is nowpossible to run simulations that enable us to build twenty-year projections for overall baseline and optimistic incidence/prevalence rates. In order to do so, we must go through three simulations. The results appear in the tables in Section B.The first simulation accounts for changes in demographic factors 44 (age and race) only, holding behavioral risk factors attheir 2003 values.The second simulation accounts for baseline projections of Model 2 and Model 3, accounting for behavioral risk factorsplus available screening and treatment options. We apply the percent changes between the results the first and secondsimulations to the age-driven demographic projections established in Model 1. This will give us final baseline incidenceand prevalence projections.The third simulation is the same as the second but accounts for optimistic risk factor projections plus available optimisticscreening and treatment options. Similarly, optimistic and incidence and prevalence projections are completed by applyingthe percent changes between the second and third simulations to the final baseline established in the second simulation.The incidence/prevalence rates must next be converted to PRC projections to reference back to the established MEPSregional data. We will base the projections on the annual incidence/prevalence projections from the preceding baselineand optimistic scenarios. (In the case of cancers, PRC will be greater than incidence because the MEPS PRC totals includeprevalence as well as incidence.) These are reasonably good proxies for cancer PRC projections, and because theyassume that PRC totals rise at the same rate as incidence, they may understate PRC since individuals will be living longerwith the condition.44. See the table “Pooled Cross-Sectional Models,” page 86.[ 88 ]