Supplementarytable 1. Data source and definition of included health care costs.

Cost Component
Data Source / Definition
Non-Drug Costs / Physician Encounters
Ontario Health Insurance Plan / Costs of services offered by general practitioners and specialty physicians.
Based on physician claims for outpatient, inpatient, community-based, and laboratory services, under the provincial health plan. 95% of physicians in the province have a few for service or blended payment practice under this plan.
Non-Physician Provider Encounters
Ontario Health Insurance Plan / Cost of services offered by non-physician healthcare providers (e.g. physiotherapist, occupational therapist, dietician) covered by OHIP.
Laboratory Tests / Laboratory tests performed on an ambulatory basis.
Emergency Department Visits*
CIHI: National Ambulatory Care Reporting System / Cost of emergency department visits.
Cancer Centre Visits*
CIHI: National Ambulatory Care Reporting System / Cost of visits to regional cancer centres.
Inpatient Care*
CIHI: Discharge Abstract Database / Cost of inpatient hospitalizations, including all aspects of patient care.
Same Day Surgery*
CIHI: Discharge Abstract Database / Cost of ambulatory surgical care.
Home Care Services*
Ontario Association of Community Care Access Centres / Costs of home care services provided to patients outside of the hospital. Those are government-funded services coordinated by the provincial Community Care Access Centres.
Rehabilitation*
CIHI: National Rehabilitation Reporting System / Cost of adult rehabilitation services (in rehabilitation institutions).
Long-Term Care*
CIHI: Continuing Care Reporting System / Cost of days of care provided to patients in long-term care institutions, which cares for adults who require 24-hour nursing and personal care, frequent assistance of daily living, and on-site supervision or monitoring to ensure patient’s safety.
Complex Continuing Care*
CIHI: Continuing Care Reporting System / Cost of days of facility based continuing care, which provides in-hospital care to patients with chronic conditions requiring complex and specialized health services over extended periods of time needs. It includesmedical long term care, rehabilitation, geriatric assessment, respite care, palliative care, and nursing home care, for health services that typically require skilled, technology-based care that is not available at home or in long-term care facilities.
Drug Costs / Health Plan Medications
Ontario Drug Benefit (ODB) / Cost of prescription medications dispensed to the population in community pharmacies and long term care/nursing facilities.
Patients meeting one of the following criteria are covered under the ODB plan: 65 years of age and older, resident of a long-term care facility, recipient of services under the Home Care Program, registered under the Trillium Drug Program (for patients whose costs of medication exceeds the capacity of their income), recipient of social assistance, registered under the Special Drugs Program. This includes oral chemotherapy.
Cancer Medications and Chemotherapies
Cancer Care Ontario: New Drug Funding Program (NDFP), / Costs of high cost medications.
The NDFP (created in 1995) funds high costs medications, includingnew and often expensive systemic therapies.

$CND Canadian dollars; CIHI Canadian Institute for Health Information

* Physician fees associated with the services are evaluated by physician billings under “Physician Encounters.

Supplementary Table 2. Detailed mean costs per patient (2012$CAD) byphase of care, comparing matched neuroendocrine tumors and colon cancers.

Table 2.1. Pre-diagnostic phase (- 2 years to – 181 days)

Neuroendocrine Tumor / Colon Cancer / p-value
Physician Encounters / 1,681 (1,607, 1,756) / 1,328 (1,290, 1,366) / 0.001
Non-Physician Provider Encounters / 51 (44, 58) / 48 (44, 52) / 0.468
Non-Inpatient Laboratory Tests / 192 (184, 200) / 169 (164, 173) / 0.001
Emergency Department Visits / 272 (248, 296) / 194 (185, 204) / 0.001
Inpatient Care / 1,585 (1,301, 1,869) / 1,352 (1,223, 1,481) / 0.096
Same Day Surgery / 292 (263, 321) / 244 (223, 266) / 0.019
Home Care Services / 229 (179, 279) / 339 (284, 394) / 0.025
Rehabilitation / 135 (72, 197) / 161 (108, 215) / 0.587
Long-Term Care / 194 (89, 298) / 345 (262, 428) / 0.051
Complex Continuing Care / 49 (-27, 124) / 101 (18, 185) / 0.481
Subtotal: Non-drug costs / 4,678 (4,248, 5,109) / 4,282 (4,036, 4,527) / 0.108
Subtotal: Drug cost / 1,199 (1,032, 1,366) / 1,086 (1,039, 1,134) / 0.083
Total / 5,877 (5,398, 6,357) / 5,368 (5,102, 5,633) / 0.058

Values are mean cost per patient (95%CI) in 2012$CAD.

Table 2.2. Diagnostic phase (- 180 days to + 180 days)

Neuroendocrine Tumor / Colon Cancer / p-value
Physician Encounters / 5,573 (5,371, 5,775) / 6,221 (6,135, 6,306) / 0.001
Non-Physician Provider Encounters / 29 (25, 33) / 32 (29, 34) / 0.305
Non-Inpatient Laboratory Tests / 219 (212, 226) / 203 (199, 207) / 0.001
Emergency Department Visits / 692 (661, 724) / 698 (681, 716) / 0.735
Cancer Clinic Visits / 2,266 (2,059, 2,474) / 3,806 (3,682, 3,929) / 0.001
Inpatient Care / 14,130 (13,287, 14,972) / 18,054 (17,539, 18,569) / 0.001
Same Day Surgery / 791 (757, 825) / 745 (727, 764) / 0.016
Home Care Services / 1,109 (1,028, 1,191) / 2,007 (1,941, 2,073) / 0.001
Rehabilitation / 491 (327, 655) / 597 (489, 706) / 0.312
Long-Term Care / 208 (130, 287) / 331 (268, 394) / 0.037
Complex Continuing Care / 351 (232, 470) / 417 (321, 513) / 0.461
Subtotal: Non-drug costs / 25,860 (24,775, 26,944) / 33,111 (32,463, 33,758) / 0.001
Subtotal: Drug cost / 1,581 (1,442, 1,719) / 3,512 (3,403, 3,622) / 0.001
Total / 27,441 (26,334, 28,547) / 36,623 (35,955, 37,291) / 0.001

Values are mean cost per patient (95%CI) in 2012$CAD.

Table 2.3. Post-diagnostic phase (+181 days to + 3 years)

Neuroendocrine Tumor / Colon Cancer / p-value
Physician Encounters / 5,615 (5,366, 5,864) / 6,753 (6,422, 7,083) / 0.001
Non-Physician Provider Encounters / 97 (81, 112) / 100 (91, 109) / 0.71
Non-Inpatient Laboratory Tests / 411 (390, 432) / 366 (356, 376) / 0.001
Emergency Department Visits / 615 (562, 667) / 610 (581, 638) / 0.865
Cancer Clinic Visits / 2,160 (1,834, 2,486) / 6,194 (5,885, 6,504) / 0.001
Inpatient Care / 7,367 (6,470, 8,264) / 7,726 (7,218, 8,234) / 0.492
Same Day Surgery / 797 (739, 855) / 1,072 (1,041, 1,103) / 0.001
Home Care Services / 1,637 (1,404, 1,870) / 2,732 (2,563, 2,902) / 0.001
Rehabilitation / 428 (255, 600) / 410 (310, 509) / 0.859
Long-Term Care / 735 (429, 1,042) / 913 (708, 1,118) / 0.382
Complex Continuing Care / 723 (247, 1,198) / 601 (322, 881) / 0.671
Subtotal: Non-drug costs / 20,583 (18,967, 22,200) / 27,477 (26,442, 28,513) / 0.001
Subtotal: Drug cost / 8,250 (7,315, 9,185) / 7,130 (6,780, 7,479) / 0.007
Total / 28,834 (26,788, 30,879) / 34,607 (33,376, 35,838) / 0.001

Values are mean cost per patient (95%CI) in 2012$CAD.

Table 2.4. Prolonged post-diagnostic phase (+181 days to + 9 years)

Neuroendocrine Tumor / Colon Cancer / p-value
Physician Encounters / 13,097 (11,329, 14,865) / 12,433 (11,446, 13,419) / 0.501
Non-Physician Provider Encounters / 327 (158, 497) / 321 (235, 407) / 0.942
Non-Inpatient Laboratory Tests / 1,102 (918, 1,285) / 1,064 (976, 1,153) / 0.69
Emergency Department Visits / 1,382 (911, 1,853) / 1,331 (1,120, 1,541) / 0.822
Cancer Clinic Visits / 2,529 (1,322, 3,736) / 4,431 (3,504, 5,357) / 0.026
Inpatient Care / 12,584 (8,961, 16,207) / 11,309 (9,015, 13,603) / 0.564
Same Day Surgery / 1,947 (1,534, 2,360) / 2,764 (2,541, 2,988) / 0.001
Home Care Services / 2,791 (1,467, 4,115) / 2,788 (1,993, 3,583) / 0.997
Rehabilitation / 1,243 (225, 2,261) / 593 (171, 1,016) / 0.171
Long-Term Care / 1,254 (-833, 3,341) / 2,557 (819, 4,295) / 0.41
Complex Continuing Care / 335 (-140, 809) / 420 (-45, 886) / 0.835
Subtotal: Non-drug costs / 38,591 (31,136, 46,047) / 40,012 (35,252, 44,771) / 0.757
Subtotal: Drug cost / 26,788 (14,370, 39,207) / 7,827 (6,656, 8,998) / 0.001
Total / 65,380 (48,925, 81,835) / 47,839 (42,331, 53,346) / 0.011

Values are mean cost per patient (95%CI) in 2012$CAD.