Healthcare costs of breast, prostate, colorectal and lung cancer care by clinical stage and cost component = Costes de la atención de los cánceres de mama, próstata, colorrectal y pulmón por estadio clínico y componente de coste

Abstract

Objective: To measure 3-year care costs of breast, prostate, colorectal and lung cancers disaggregated bysite and clinical stage.Method: A retrospective observational design was employed to investigate care costs of cases recordedin the Registry of the Basque Country between 2010 and 2015. Data gathered included TNM stageand demographic, clinical and resource use variables. Total costs per patient with stage IV dis-ease were calculated by combining generalized linear models with parametric survival analysis. Unitcosts were obtained from the analytical accounting system of the Basque Health Service.Results: The sample comprised 23,782 cancer cases (7801 colorectal, 5530 breast, 4802 prostate and5649 lung cancer). The mean 3-year costs per patient with stage I to III disease were D 11,323, D 13,727,D 8,651 and D 12,023 for colorectal, breast, prostate and lung cancer, respectively. The most importantcost components were surgery and chemotherapy. Total survival-adjusted costs until death for patientswith stage IV disease (D 27,568, D 26,296, D 16,151 and D 15,931 for breast, colorectal, lung and prostatecancer, respectively) were higher than the 3-year costs for those with earlier-stage disease.Conclusions: This study quantitatively shows the pattern of changes in the economic burden of cancerthroughout its natural history and the great magnitude of this burden for the health system. The use ofindicators based on real-world data from each regional health service would allow cancer care in eachregion to be tailored to local population needs.

Objetivo: Determinar el coste del tratamiento de los cánceres de mama, próstata, colorrectal y pulmónsegún la localización y el estadio clínico.Método: Se utilizó un dise ̃no observacional retrospectivo con los casos del Registro de Euskadi entre2010 y 2015. Los datos incluyeron el estadio TNM, variables demográficas y clínicas, y uso de recursos.Los costes totales por paciente en estadio IV se calcularon combinando modelos lineales generalizados conel análisis paramétrico de supervivencia. Los costes unitarios se obtuvieron del sistema de contabilidadanalítica del Servicio Vasco de Salud.Resultados: La muestra estuvo compuesta por 23.782 casos (7801 colorrectal, 5530 de mama, 4802 depróstata y 5649 de pulmón). Los costes medios por paciente a 3 a ̃nos en estadio I a III fueron 11.323 D ,13.727 D , 8651 D y 12.023 D para los cánceres colorrectal, de mama, de próstata y de pulmón, respectiva-mente. Los costes para el estadio IV (27.568 D , 26.296 D , 16.151 D y 15.931 D para los cánceres de mama,colorrectal, de pulmón y de próstata, respectivamente) fueron mayores que en los estadios iniciales.