The cost and burden of cancer in the European Union 1995-2014
The cost and burden of cancer in the European Union 1995-2014
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DOI：
10.1016/j.ejca.2016.06.022
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发表时间：
2016-10-01
影响因子：
8.4
通讯作者：
Wilking, Nils
中科院分区：
文献类型：
--
作者：
Jonsson, Bengt;Hofmarcher, Thomas;Wilking, Nils
背景：关于癌症的成本和新治疗方法的价值存在激烈的争论。然而，关于欧洲联盟（欧盟）癌症成本以及成本与疾病负担之间关系的数据有限。本文提出了新的估计癌症的成本在欧盟1995-2014年的发展，重点是主要的成本组成部分：总卫生支出，抗癌药物，生产损失由于过早mortality.Methods：数据的整体卫生支出相结合，国家疾病估计，以获得癌症的具体卫生支出。药物销售数据来自IMS Health，流行病学数据用于计算癌症导致的生命年损失。欧盟用于癌症的卫生支出从1995年的357亿欧元持续增加到2014年的832亿欧元，用于癌症药物的支出从2005年的76亿欧元增加到2014年的191亿欧元（现价）。然而，用于治疗癌症的医疗支出在总支出中所占份额基本保持不变（约6%）。虽然癌症药物的支出在绝对值和相对值上都有所增加，但其他支出保持稳定或有所减少，尽管人口不断增长和老龄化导致癌症发病率上升。工作年龄段癌症死亡率的降低导致了因过早死亡而造成的生产损失的减少。解释：尽管癌症的发病率和相对负担不断增加，但用于癌症的卫生支出在卫生总支出中所占的份额相当低且稳定。在经济压力下重新分配医疗保健系统资金的问题可能是一种解释，将住院费用转移到门诊费用可能是另一种解释。(C)2016爱思唯尔有限公司版权所有
Background: There is an intense debate about the cost of cancer and the value of new treatments. However, there is limited data on the cost of cancer in the European Union (EU) and howcosts relate to the burden of disease. This paper presents new estimates on the development of the cost of cancer in the EU 1995-2014, with a focus on the major cost components: total health expenditure, cancer drugs, and production loss due to premature mortality.Methods: Data on overall health expenditure were combined with national disease estimates to derive cancer-specific health expenditure. Data on drug sales were obtained from IMS Health, and epidemiological data were used to calculate life years lost due to cancer.Findings: Health expenditure on cancer increased continuously from (sic)35.7 billion in 1995 to (sic)83.2 billion in 2014 in the EU and spending on cancer drugs from (sic)7.6 billion in 2005 to (sic)19.1 billion in 2014 (current prices). Yet the share of total health expenditure devoted to cancer was mostly constant (around 6 per cent). While expenditures on cancer drugs increased in both absolute and relative terms, other expenditures were stable or decreased, despite increases in cancer incidence driven by a growing and ageing population. Reductions in cancer mortality during working age resulted in decreasing production loss due to premature mortality.Interpretation: Health spending on cancer as a share of total health expenditure is rather low and stable despite the growing incidence and relative burden of cancer. Problems to reallocate funding in health care systems under economic pressure may be one explanation and shifting costs from inpatient to ambulatory care another. (C) 2016 Elsevier Ltd. All rights reserved.