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

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An Unhealthy AmericaMilken InstituteExpenditures Baseline PRC* Expenditures/PRCOptimisticChronic Disease 2003 (Billions) 2013 2023 (Millions) 2003 (Thousands) 2013 2023Cancer Cancer 4,541 6,173 48.1 8,512 10.6 4,541 5,857 4.5 7,709Breast Cancer 5.5 1.1 4.8Breast Cancer 4,840 6,669 9,033 4,840 6,353 8,196Colon Cancer 3.9 0.3 11.5ColonLungCancerCancer11,549 16,6056.323,4840.411,549 15,82217.121,319Lung Cancer Prostate Cancer 17,088 23,571 4.3 31,9631.0 17,088 22,454 4.1 29,004Prostate Other Cancer Cancers 4,100 5,711 28.0 7,8217.7 4,100 5,441 3.6 7,097Other Pulmonary Cancers Conditions3,644 5,09945.27,01449.23,644 4,8580.96,366Diabetes 27.1 13.7 2.0Pulmonary Conditions 919 1,299 1,814 919 1,238 1,646Hypertension 32.5 36.8 0.9Diabetes Heart Disease 1,977 2,750 64.7 3,780 19.2 1,977 2,620 3.4 3,431Hypertension Stroke 885 1,231 13.6 1,6942.4 885 1,173 5.6 1,538Heart Disease Mental Disorders 3,381 4,841 45.8 6,826 30.3 3,381 4,612 1.5 6,196TotalStroke 5,596277.08,084162.211,500 5,5961.77,703 10,440PRC: Population Reporting ConditionMental Disorders 1,509 2,091 2,862 1,509 1,992 2,597Source: Milken InstituteExpendituresExpendituresper PRCper- U.S.PRCDollarsWe calculate total expenditure projections by multiplying PRC by expenditures per PRC outward for twenty years.TotalTotalExpenditureExpenditureProjections*Projections*- US$ BillionsUS$ BillionsExpendituresBaseline PRC* Expenditures/PRCOptimisticDisease(Billions) (Millions) (Thousands)Chronic Disease 2003 2013 2023 2003 2013 2023Cancer 48.1 10.6 4.5Cancer 48.1 86.6 146.3 48.1 77.6 108.9Breast Cancer Breast Cancer 5.5 9.7 5.5 15.6 1.1 5.5 4.89.1 12.4Colon Cancer Colon Cancer 3.9 6.1 3.9 10.6 0.3 3.9 11.55.3 7.9Lung Cancer Lung Cancer 6.3 9.6 6.3 16.1 0.4 6.3 17.18.4 11.9Prostate Cancer Prostate Cancer 4.3 8.3 4.3 14.2 1.0 4.3 4.17.6 10.1Other Cancers Other Cancers 28.0 52.8 28.0 89.7 7.7 28.0 3.6 47.3 66.6Pulmonary Pulmonary Conditions Conditions45.2 72.6 45.2 118.249.2 45.2 0.9 65.3 92.0Diabetes Diabetes 27.1 48.8 27.1 79.713.7 27.1 2.0 45.3 62.6Hypertension Hypertension 32.5 55.8 32.5 88.136.8 32.5 0.9 49.2 64.9Heart Disease Heart Disease 64.7 112.3 64.7 186.019.2 64.7 3.4 92.8 110.1Stroke Stroke 13.6 22.0 13.6 36.6 2.4 13.6 5.6 19.4 26.9Mental Disorders Mental Disorders 45.8 77.2 45.8 135.230.3 45.8 1.5 70.6 107.2Total Total 277.0 475.3 277.0 790.0 162.2 277.0 420.2 1.7 572.4*Total medical expenditureSource: Milken PRC: Institute Population Reporting ConditionB: Avoidable Costs by DiseaseThis section provides the disease-specific baseline and optimistic projections of PRC and expenditures. The differencebetween the scenarios will be the avoidable direct costs.[ 91 ]
An Unhealthy AmericaMilken InstituteSummary Table – Avoided CostsThe next table below summarizes the differences between the optimistic and baseline projection scenarios in absoluteand percentage totals of avoidable direct costs. As shown, more than 40 million cases of chronic conditions could beavoided, resulting in avoided treatment costs of $217.6 billion annually in 2023, a 27.5 percent savings.2023 Avoidable Cost Projections2023 Avoidable Cost Difference Projections Between - Difference Baseline and Between Optimistic Baseline Projections and Optimistic ProjectionsPRCExpendituresExpendituresPRC*per PRCExpenditures/PRCTotal ExpendituresDisease Absolute (Billions) Absolute (Millions) (Thousands) AbsoluteChronic Disease Cancer (Thousands) Percent 48.1 ($) 10.6Percent(US$ 4.5 Billions) PercentCancer Breast Cancer -3,060 -17.8 5.5 -803 1.1 -9.4 4.8 -37 -25.6Breast Cancer Colon Cancer -211 -12.3 3.9 -836 0.3 -9.3 11.5 -3.2 -20.6Colon Cancer Lung Cancer -79 -17.7 6.3-2,166 0.4 -9.2 17.1 -2.7 -25.5Lung Cancer Prostate Cancer -91 -18.4 4.3-2,959 1.0 -9.3 4.1 -4.2 -26.2Prostate CancerOther Cancers -393 -21.5 28.0 -723 7.7 -9.2 3.6 -4.1 -28.9Other CancersPulmonary Conditions -2,285 -18.0 45.2 -649 49.2 -9.2 0.9-23.1 -25.8Pulmonary Conditions Diabetes -9,078 -14.1 27.1 -167 13.7 -9.2 2.0-26.2 -22.2Diabetes Hypertension-2,791 -13.3 32.5 -350 36.8 -9.2 0.9-17.1 -21.5Hypertension Heart Disease -9,561 -18.7 64.7 -157 19.2 -9.2 3.4-23.3 -26.4Heart Disease Stroke -9,354 -34.6 13.6 -630 2.4 -9.2 5.6-75.8 -40.8StrokeMental Disorders-589 -18.845.8-1,06030.3-9.21.5-9.7 -26.5Mental DisordersTotal -5,763 -12.3 277.0 -265 162.2 -9.3 1.7-28.0 -20.7Total PRC: Population -40,196 Reporting Condition -17.4 – – -217.6 -27.5Source: Milken InstituteCumulatively over two decades, the direct avoidable treatment cost totals $1.6 trillion for all chronic diseases in this study.Avoidable Avoidable Direct Costs Direct - US$ Costs BillionsUS$ BillionsExpendituresCumulative Sum PRC* Expenditures/PRCDisease(Billions) 2004-2023 (Millions) (Thousands)Cancer Chronic Disease Baseline48.1 Optimistic 10.6 Avoidable 4.5Costs*Cancer Breast Cancer 1,850 5.5 1,578 1.1 -272.0 4.8BreastColonCancer 2053.91830.3 11.5-22.3Lung Cancer 208 176 -32.4Lung Cancer 6.3 0.4 17.1Colon Cancer 134 112 -21.7ProstateProstateCancerCancer1784.31501.0 4.1-27.2Other Other Cancers Cancers 1,126 28.0 958 7.7 -168.5 3.6Diabetes Pulmonary Conditions 1,032 45.2 913 49.2 -118.5 0.9Heart Diabetes Disease 2,392 27.1 1,830 13.7 -561.7 2.0Pulmonary Hypertension Conditions 1,551 32.5 1,352 36.8 -199.6 0.9Hypertension Heart Disease 1,172 64.7 992 19.2 -179.6 3.4Stroke 470 13.6 3972.4 5.6 -72.7MentalMentalDisordersDisorders1,67945.81,48330.3-196.61.5Total 10,146 8,545 1,600.8Total 277.0 162.2 1.7*Sums of Differences between Baseline and Optimistic ProjectionsSource: PRC: Population Milken Institute Reporting Condition[ 92 ]
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