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      Economic burden of lung cancer in Turkey: a cost of illness study from payer perspective

      research-article
      Author(s): 1 , 2 , , 3 , 4 , 5 , 6 , 7 , 7 , 7 , 7 , 8 , Lung Cancer Report Study Group Turkey, on behalf of the Turkish Society of Lung Cancer, Lung Health and Intensive Care Association, University of Health Sciences, Turkish Society of Medical Oncology, National Cancer Institute, Turkish Respiratory Society
      Publication date (Electronic):
      Journal: Health Economics Review
      Publisher: Springer Berlin Heidelberg
      Keywords: Lung cancer, Practice patterns, Cost of illness, Direct costs, Indirect costs, Economic burden, Turkey

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          Abstract

          Background

          This study was designed to estimate economic burden of lung cancer in Turkey from payer perspective based on expert panel opinion on practice patterns in clinical practice.

          Methods

          In this cost of illness study, direct medical cost was calculated based on cost items related to outpatient visits, laboratory and radiological tests, hospitalizations/interventions, drug treatment, adverse events and metastasis. Indirect cost was calculated based on lost productivity due to early retirement, morbidity and premature death resulting from the illness, the value of lost productivity due to time spent by family caregivers and cost of formal caregivers.

          Results

          Cost analysis revealed the total per patient annual direct medical cost for small cell lung cancer to be €8772), for non-small-cell lung cancer to be €10,167. Total annual direct medical cost was €497.9 million, total annual indirect medical cost was €1.1 billion and total economic burden of lung cancer was €1.6 billion. Hospitalization/interventions (41%) and indirect costs (68.6%) were the major cost drivers for total direct costs and the overall economic burden of lung cancer, respectively.

          Conclusions

          Our findings indicate per patient direct medical costs of small cell lung cancer and non-small-cell lung cancer to be substantial and comparable, indicating the substantial economic burden of lung cancer in terms of both direct and indirect costs. Our findings indicate that hospitalization/interventions cost item and indirect costs were the major cost drivers for total direct costs and the overall economic burden of lung cancer, respectively. Our findings emphasize the potential role of improved cancer prevention and early diagnosis strategies, by enabling cost savings related to drug treatment and metastasis management cost items, in sustainability of cancer treatments.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s13561-021-00322-2.

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          Most cited references41

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          Global Cancer Incidence and Mortality Rates and Trends--An Update

          L. A. Torre, R L Siegel, E Ward … (2016)
          There are limited published data on recent cancer incidence and mortality trends worldwide. We used the International Agency for Research on Cancer's CANCERMondial clearinghouse to present age-standardized cancer incidence and death rates for 2003-2007. We also present trends in incidence through 2007 and mortality through 2012 for select countries from five continents. High-income countries (HIC) continue to have the highest incidence rates for all sites, as well as for lung, colorectal, breast, and prostate cancer, although some low- and middle-income countries (LMIC) now count among those with the highest rates. Mortality rates from these cancers are declining in many HICs while they are increasing in LMICs. LMICs have the highest rates of stomach, liver, esophageal, and cervical cancer. Although rates remain high in HICs, they are plateauing or decreasing for the most common cancers due to decreases in known risk factors, screening and early detection, and improved treatment (mortality only). In contrast, rates in several LMICs are increasing for these cancers due to increases in smoking, excess body weight, and physical inactivity. LMICs also have a disproportionate burden of infection-related cancers. Applied cancer control measures are needed to reduce rates in HICs and arrest the growing burden in LMICs.
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            Projections of the cost of cancer care in the United States: 2010-2020.

            Angela Mariotto, K Robin Yabroff, Yongwu Shao … (2011)
            Current estimates of the costs of cancer care in the United States are based on data from 2003 and earlier. However, incidence, survival, and practice patterns have been changing for the majority of cancers. Cancer prevalence was estimated and projected by phase of care (initial year following diagnosis, continuing, and last year of life) and tumor site for 13 cancers in men and 16 cancers in women through 2020. Cancer prevalence was calculated from cancer incidence and survival models estimated from Surveillance, Epidemiology, and End Results (SEER) Program data. Annualized net costs were estimated from recent SEER-Medicare linkage data, which included claims through 2006 among beneficiaries aged 65 years and older with a cancer diagnosis. Control subjects without cancer were identified from a 5% random sample of all Medicare beneficiaries residing in the SEER areas to adjust for expenditures not related to cancer. All cost estimates were adjusted to 2010 dollars. Different scenarios for assumptions about future trends in incidence, survival, and cost were assessed with sensitivity analysis. Assuming constant incidence, survival, and cost, we projected 13.8 and 18.1 million cancer survivors in 2010 and 2020, respectively, with associated costs of cancer care of 124.57 and 157.77 billion 2010 US dollars. This 27% increase in medical costs reflects US population changes only. The largest increases were in the continuing phase of care for prostate cancer (42%) and female breast cancer (32%). Projections of current trends in incidence (declining) and survival (increasing) had small effects on 2020 estimates. However, if costs of care increase annually by 2% in the initial and last year of life phases of care, the total cost in 2020 is projected to be $173 billion, which represents a 39% increase from 2010. The national cost of cancer care is substantial and expected to increase because of population changes alone. Our findings have implications for policy makers in planning and allocation of resources.
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              Economic burden of cancer across the European Union: a population-based cost analysis.

              Richard T. Sullivan, António Leal, Ramón Fernández de Bobadilla … (2013)
              In 2008, 2·45 million people were diagnosed with cancer and 1·23 million died because of cancer in the 27 countries of the European Union (EU). We aimed to estimate the economic burden of cancer in the EU. In a population-based cost analysis, we evaluated the cost of all cancers and also those associated with breast, colorectal, lung, and prostate cancers. We obtained country-specific aggregate data for morbidity, mortality, and health-care resource use from international and national sources. We estimated health-care costs from expenditure on care in the primary, outpatient, emergency, and inpatient settings, and also drugs. Additionally, we estimated the costs of unpaid care provided by relatives or friends of patients (ie, informal care), lost earnings after premature death, and costs associated with individuals who temporarily or permanently left employment because of illness. Cancer cost the EU €126 billion in 2009, with health care accounting for €51·0 billion (40%). Across the EU, the health-care costs of cancer were equivalent to €102 per citizen, but varied substantially from €16 per person in Bulgaria to €184 per person in Luxembourg. Productivity losses because of early death cost €42·6 billion and lost working days €9·43 billion. Informal care cost €23·2 billion. Lung cancer had the highest economic cost (€18·8 billion, 15% of overall cancer costs), followed by breast cancer (€15·0 billion, 12%), colorectal cancer (€13·1 billion, 10%), and prostate cancer (€8·43 billion, 7%). Our results show wide differences between countries, the reasons for which need further investigation. These data contribute to public health and policy intelligence, which is required to deliver affordable cancer care systems and inform effective public research funds allocation. Copyright © 2013 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                Irfan Cicin: irfancicin@hotmail.com
                Ergun Oksuz:
                ORCID: http://orcid.org/0000-0002-5723-5965
                eoksuz@baskent.edu.tr
                Nuri Karadurmus: drnkaradurmus@yahoo.com
                Simten Malhan: simtenmalhan1@gmail.com
                Mahmut Gumus: mgumus@superonline.com
                Ulku Yilmaz: ulkuylmz@gmail.com
                Levent Cansever: lcansever@yahoo.com
                Halit Cinarka: halitcinarka@hotmail.com
                Erdogan Cetinkaya: erdogan.cetinkaya@sbu.edu.tr
                Murat Kiyik: muratkiyik1959@yahoo.com
                Ahmet Ozet: ahmetozet@gmail.com
                Journal
                Journal ID (nlm-ta): Health Econ Rev
                Journal ID (iso-abbrev): Health Econ Rev
                Title: Health Economics Review
                Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )
                ISSN (Electronic): 2191-1991
                Publication date (Electronic): 26 June 2021
                Publication date PMC-release: 26 June 2021
                Publication date Collection: 2021
                Volume: 11
                Electronic Location Identifier: 22
                Affiliations
                [1 ]GRID grid.411693.8, ISNI 0000 0001 2342 6459, Department of Medical Oncology, Faculty of Medicine, , Trakya University, ; Edirne, Turkey
                [2 ]GRID grid.411548.d, ISNI 0000 0001 1457 1144, Department of Family Medicine, Faculty of Medicine, , Baskent University, ; Baglica Kampusu 06770, Etimesgut, Ankara, Turkey
                [3 ]Gulhane Training and Research Hospital, Ankara, Turkey
                [4 ]GRID grid.411548.d, ISNI 0000 0001 1457 1144, Faculty of Health Sciences, , Baskent University, ; Ankara, Turkey
                [5 ]GRID grid.411776.2, ISNI 0000 0004 0454 921X, Faculty of Medicine, , Istanbul Medeniyet University, ; Istanbul, Turkey
                [6 ]University of Health Sciences, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
                [7 ]Yedikule Chest Disease and Thoracic Surgery Health Application and Research Center, University Of Health Sciences, Istanbul, Turkey
                [8 ]GRID grid.25769.3f, ISNI 0000 0001 2169 7132, Faculty of Medicine, , Gazi University, ; Ankara, Turkey
                Author information
                http://orcid.org/0000-0002-5723-5965
                Article
                Publisher ID: 322
                DOI: 10.1186/s13561-021-00322-2
                PMC ID: 8233643
                PubMed ID: 34173876
                SO-VID: 4e5fb130-0413-4dfd-9cdf-9b8e7c0d3087
                Copyright © © The Author(s) 2021
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 27 January 2021
                Date accepted : 11 June 2021
                Funding
                Funded by: AstraZeneca Turkey
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2021

                ScienceOpen disciplines: Economics of health & social care
                Keywords: lung cancer,practice patterns,cost of illness,direct costs,indirect costs,economic burden,turkey
                Data availability:
                ScienceOpen disciplines: Economics of health & social care
                Keywords: lung cancer, practice patterns, cost of illness, direct costs, indirect costs, economic burden, turkey

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