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End-of-life costs of medical care for advanced stage cancer patients

Kovacević, Aleksandra ; Dragojević-Simić, Viktorija ; Rancić, Nemanja ; Jurisević, Milena ; Gutzwiller, Florian ; Gutzwiller, Florian ; Matter-Walstra, Klazien and Jakovljević, Mihajlo LU (2015) In Vojnosanitetski Pregled 72(4). p.41-334
Abstract

BACKGROUND/AIM: Cancer, one of the leading causes of mortality in the world, imposes a substantial economic burden on each society, including Serbia. The aim of this study was to evaluate the major cancer cost drivers in Serbia.

METHODS: A retrospective, in-depth, bottom-up analysis of two combined databases was performed in order to quantify relevant costs. End-of-life data were obtained from patients with cancer, who deceased within the first year of the established diagnose, including basic demographics, diagnosis, tumour histology, medical resource use and related costs, time and cause of death. All costs were allocated to one of the three categories of cancer health care services: primary care (included home care), hospital... (More)

BACKGROUND/AIM: Cancer, one of the leading causes of mortality in the world, imposes a substantial economic burden on each society, including Serbia. The aim of this study was to evaluate the major cancer cost drivers in Serbia.

METHODS: A retrospective, in-depth, bottom-up analysis of two combined databases was performed in order to quantify relevant costs. End-of-life data were obtained from patients with cancer, who deceased within the first year of the established diagnose, including basic demographics, diagnosis, tumour histology, medical resource use and related costs, time and cause of death. All costs were allocated to one of the three categories of cancer health care services: primary care (included home care), hospital outpatient and hospital inpatient care.

RESULTS: Exactly 114 patients were analyzed, out of whom a high percent (48.25%) had distant metastases at the moment of establishing the diagnosis. Malignant neoplasms of respiratory and intrathoracic organs were leading causes of morbidity. The average costs per patient were significantly different according to the diagnosis, with the highest (13,114.10 EUR) and the lowest (4.00 EUR) ones observed in the breast cancer and melanoma, respectively. The greatest impact on total costs was observed concerning pharmaceuticals, with 42% of share (monoclonal antibodies amounted to 34% of all medicines and 14% of total costs), followed by oncology medical care (21%), radiation therapy and interventional radiology (11%), surgery (90%), imaging diagnostics (9%) and laboratory costs (8%). CONCLUSION. Cancer treatment incurs high costs, especially for end-of-life pharmaceutical expenses, ensued from medical personnel tendency to improve such patients' quality of life in spite of nearing the end of life. Reimbursement policy on monoclonal antibodies, in particular at end-stage disease, should rely on cost-effectiveness evidence as well as documented clinical efficiency.

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Please use this url to cite or link to this publication:
author
; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Aged, Antibodies, Monoclonal/economics, Antineoplastic Agents/economics, Combined Modality Therapy/economics, Female, Health Care Costs/statistics & numerical data, Humans, Male, Middle Aged, Neoplasm Staging, Neoplasms/economics, Quality of Life, Retrospective Studies, Serbia, Terminal Care/economics
in
Vojnosanitetski Pregled
volume
72
issue
4
pages
41 - 334
publisher
Institut za Vojnomedicinske Naucne Informacije/Documentaciju
external identifiers
  • scopus:84920288589
  • pmid:26040179
ISSN
0042-8450
language
English
LU publication?
no
id
ca941035-85ad-4023-b28c-3938c62844d0
alternative location
http://www.vma.mod.gov.rs/VSP_04_2015.pdf
date added to LUP
2018-09-01 22:53:54
date last changed
2024-01-29 20:15:53
@article{ca941035-85ad-4023-b28c-3938c62844d0,
  abstract     = {{<p>BACKGROUND/AIM: Cancer, one of the leading causes of mortality in the world, imposes a substantial economic burden on each society, including Serbia. The aim of this study was to evaluate the major cancer cost drivers in Serbia.</p><p>METHODS: A retrospective, in-depth, bottom-up analysis of two combined databases was performed in order to quantify relevant costs. End-of-life data were obtained from patients with cancer, who deceased within the first year of the established diagnose, including basic demographics, diagnosis, tumour histology, medical resource use and related costs, time and cause of death. All costs were allocated to one of the three categories of cancer health care services: primary care (included home care), hospital outpatient and hospital inpatient care.</p><p>RESULTS: Exactly 114 patients were analyzed, out of whom a high percent (48.25%) had distant metastases at the moment of establishing the diagnosis. Malignant neoplasms of respiratory and intrathoracic organs were leading causes of morbidity. The average costs per patient were significantly different according to the diagnosis, with the highest (13,114.10 EUR) and the lowest (4.00 EUR) ones observed in the breast cancer and melanoma, respectively. The greatest impact on total costs was observed concerning pharmaceuticals, with 42% of share (monoclonal antibodies amounted to 34% of all medicines and 14% of total costs), followed by oncology medical care (21%), radiation therapy and interventional radiology (11%), surgery (90%), imaging diagnostics (9%) and laboratory costs (8%). CONCLUSION. Cancer treatment incurs high costs, especially for end-of-life pharmaceutical expenses, ensued from medical personnel tendency to improve such patients' quality of life in spite of nearing the end of life. Reimbursement policy on monoclonal antibodies, in particular at end-stage disease, should rely on cost-effectiveness evidence as well as documented clinical efficiency.</p>}},
  author       = {{Kovacević, Aleksandra and Dragojević-Simić, Viktorija and Rancić, Nemanja and Jurisević, Milena and Gutzwiller, Florian and Gutzwiller, Florian and Matter-Walstra, Klazien and Jakovljević, Mihajlo}},
  issn         = {{0042-8450}},
  keywords     = {{Aged; Antibodies, Monoclonal/economics; Antineoplastic Agents/economics; Combined Modality Therapy/economics; Female; Health Care Costs/statistics & numerical data; Humans; Male; Middle Aged; Neoplasm Staging; Neoplasms/economics; Quality of Life; Retrospective Studies; Serbia; Terminal Care/economics}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{41--334}},
  publisher    = {{Institut za Vojnomedicinske Naucne Informacije/Documentaciju}},
  series       = {{Vojnosanitetski Pregled}},
  title        = {{End-of-life costs of medical care for advanced stage cancer patients}},
  url          = {{http://www.vma.mod.gov.rs/VSP_04_2015.pdf}},
  volume       = {{72}},
  year         = {{2015}},
}